03D0999753 CLIA NUMBER - MAIN STREET FAMILY PRACTICE, PC

Laboratory Demographics

  • CLIA Code: 03D0999753
  • Facility Name: MAIN STREET FAMILY PRACTICE, PC
  • Facility Address: 660 S MAIN STREET
    FLORENCE, AZ
    ZIP 85232
  • Facility Phone: 520 868-1400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DARIO L. LIZARRAGA MD
  • NPI Number: 1356410146
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D0999753
LAB Type Physician Office
Facility Name MAIN STREET FAMILY PRACTICE, PC
Street 660 S MAIN STREET
City FLORENCE
State AZ
ZIP 85232
Phone 520 868-1400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2024
Certificate Expiration Date 5/20/2026
Facility Type Physician Office
Lab Director DARIO L. LIZARRAGA MD

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