03D0993162 CLIA NUMBER - MESA VERDE MEDICAL GROUP, PC

Laboratory Demographics

  • CLIA Code: 03D0993162
  • Facility Name: MESA VERDE MEDICAL GROUP, PC
  • Facility Address: 395 N SILVERBELL RD, STE 265
    TUCSON, AZ
    ZIP 85745
  • Facility Phone: 520 624-2194
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ARMANDO M. GONZALEZ
  • NPI Number: 1265637888
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D0993162
LAB Type Physician Office
Facility Name MESA VERDE MEDICAL GROUP, PC
Street 395 N SILVERBELL RD, STE 265
City TUCSON
State AZ
ZIP 85745
Phone 520 624-2194
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/10/2024
Certificate Expiration Date 1/9/2026
Facility Type Physician Office
Lab Director ARMANDO M. GONZALEZ

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