03D0706266 CLIA NUMBER - LA CHOLLA FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 03D0706266
  • Facility Name: LA CHOLLA FAMILY PRACTICE
  • Facility Address: 6130 N LA CHOLLA, STE #100
    TUCSON, AZ
    ZIP 85741
  • Facility Phone: 520 742-4159
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LOAN HAASE
  • NPI Number: 1972705184
  • Taxonomy: 122300000X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 03D0706266
LAB Type Physician Office
Facility Name LA CHOLLA FAMILY PRACTICE
Street 6130 N LA CHOLLA, STE #100
City TUCSON
State AZ
ZIP 85741
Phone 520 742-4159
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director LOAN HAASE

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