03D2303244 CLIA NUMBER - TL FAMILY NURSE PRACTICE

Laboratory Demographics

  • CLIA Code: 03D2303244
  • Facility Name: TL FAMILY NURSE PRACTICE
  • Facility Address: 13055 W MCDOWELL RD STE E-101
    AVONDALE, AZ
    ZIP 85392
  • Facility Phone: 602 918-3225
  • Facility Type: Other - FAMILY PRACTICE/STD CLINI
  • Facility Type: Waiver
  • Lab Director: LEA NICKOLAS
  • NPI Number: 1346862406
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D2303244
LAB Type Other - FAMILY PRACTICE/STD CLINI
Facility Name TL FAMILY NURSE PRACTICE
Street 13055 W MCDOWELL RD STE E-101
City AVONDALE
State AZ
ZIP 85392
Phone 602 918-3225
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/23/2024
Certificate Expiration Date 4/22/2026
Facility Type Other - FAMILY PRACTICE/STD CLINI
Lab Director LEA NICKOLAS

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