03D2274034 CLIA NUMBER - CHRYSALIS CHILDREN'S CLINIC

Laboratory Demographics

  • CLIA Code: 03D2274034
  • Facility Name: CHRYSALIS CHILDREN'S CLINIC
  • Facility Address: 1845 E BROADWAY RD STE 116
    TEMPE, AZ
    ZIP 85282
  • Facility Phone: 602 851-5353
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANGELA J. CABRERA
  • NPI Number: 1982315529
  • Taxonomy: 363LP0200X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 03D2274034
LAB Type Physician Office
Facility Name CHRYSALIS CHILDREN'S CLINIC
Street 1845 E BROADWAY RD STE 116
City TEMPE
State AZ
ZIP 85282
Phone 602 851-5353
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/22/2024
Certificate Expiration Date 12/21/2026
Facility Type Physician Office
Lab Director ANGELA J. CABRERA

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