03D2277636 CLIA NUMBER - PINAL HISPANIC COUNCIL - CASA GRANDE IC

Laboratory Demographics

  • CLIA Code: 03D2277636
  • Facility Name: PINAL HISPANIC COUNCIL - CASA GRANDE IC
  • Facility Address: 1667 N TREKELL RD STE 101
    CASA GRANDE, AZ
    ZIP 85122
  • Facility Phone: 520 721-1887
  • Facility Type: Other - BEHAVIORAL HEALTH OUTPATI
  • Facility Type: Waiver
  • Lab Director: DR. LINDSEY RETTERATH
  • NPI Number: 1669899373
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 03D2277636
LAB Type Other - BEHAVIORAL HEALTH OUTPATI
Facility Name PINAL HISPANIC COUNCIL - CASA GRANDE IC
Street 1667 N TREKELL RD STE 101
City CASA GRANDE
State AZ
ZIP 85122
Phone 520 721-1887
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/2/2025
Certificate Expiration Date 3/1/2027
Facility Type Other - BEHAVIORAL HEALTH OUTPATI
Lab Director DR. LINDSEY RETTERATH

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