03D2184859 CLIA NUMBER - STARLIGHT PEDIATRIC PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 03D2184859
  • Facility Name: STARLIGHT PEDIATRIC PRIMARY CARE
  • Facility Address: 1215 N IVY LOOP
    CASA GRANDE, AZ
    ZIP 85122
  • Facility Phone: 520 510-0087
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ONYIA G. UCHENNA
  • NPI Number: 1649825282
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 03D2184859
LAB Type Physician Office
Facility Name STARLIGHT PEDIATRIC PRIMARY CARE
Street 1215 N IVY LOOP
City CASA GRANDE
State AZ
ZIP 85122
Phone 520 510-0087
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/26/2024
Certificate Expiration Date 5/25/2026
Facility Type Physician Office
Lab Director ONYIA G. UCHENNA

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This page was last updated on: 9/29/2025