03D2185870 CLIA NUMBER - BANNER HEALTH DBA BANNER CASA GRANDE WOUND CLINIC

Laboratory Demographics

  • CLIA Code: 03D2185870
  • Facility Name: BANNER HEALTH DBA BANNER CASA GRANDE WOUND CLINIC
  • Facility Address: 1828 E FLORENCE BLVD BLDG C STE 139
    CASA GRANDE, AZ
    ZIP 85122
  • Facility Phone: 520 381-6150
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: IRENE AGUILERA-BARRANTES
  • NPI Number: 1942613435
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2185870
LAB Type Physician Office
Facility Name BANNER HEALTH DBA BANNER CASA GRANDE WOUND CLINIC
Street 1828 E FLORENCE BLVD BLDG C STE 139
City CASA GRANDE
State AZ
ZIP 85122
Phone 520 381-6150
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/10/2024
Certificate Expiration Date 6/9/2026
Facility Type Physician Office
Lab Director IRENE AGUILERA-BARRANTES

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