03D2304560 CLIA NUMBER - INNOVATIVE DIABETIC CENTER, LLC

Laboratory Demographics

  • CLIA Code: 03D2304560
  • Facility Name: INNOVATIVE DIABETIC CENTER, LLC
  • Facility Address: 10210 N 92ND ST, STE 104
    SCOTTSDALE, AZ
    ZIP 85258
  • Facility Phone: 480 493-0900
  • Facility Type: Other - DIABETIC INFUSION CLINIC
  • Facility Type: Waiver
  • Lab Director: JORDI LIVI
  • NPI Number: 1649038910
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2304560
LAB Type Other - DIABETIC INFUSION CLINIC
Facility Name INNOVATIVE DIABETIC CENTER, LLC
Street 10210 N 92ND ST, STE 104
City SCOTTSDALE
State AZ
ZIP 85258
Phone 480 493-0900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/15/2024
Certificate Expiration Date 5/14/2026
Facility Type Other - DIABETIC INFUSION CLINIC
Lab Director JORDI LIVI

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