CLIA lab
CLIA 03D1104696: Active Life Physical Medicine & Pain Center
Litchfield Park, AZ. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 03D1104696 belongs to Active Life Physical Medicine & Pain Center in Litchfield Park, AZ.
Certificate of Waiver, effective September 9, 2025, expires September 8, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- September 9, 2025
- Certificate expiration
- September 8, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 9, 2009
- Facility type
- Physician office
- Ownership (control type)
- Private
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 03D1104696
- Lab name
- Active Life Physical Medicine & Pain Center
- Address
- 13575 W Indian School Rd Suite 700, Litchfield Park, AZ 85340
- Phone
- (623) 535-9777
- Fax
- (623) 236-3179
Annual test volume the lab reported
- Waived tests
- 1,600
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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Related
Questions
What is the CLIA number for Active Life Physical Medicine & Pain Center in Litchfield Park?
03D1104696, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Active Life Physical Medicine & Pain Center hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 03D1104696 expire?
The CMS file lists September 8, 2027 as the certificate expiration date; the certificate took effect September 9, 2025.