03D1067930 CLIA NUMBER - VIDAL MEDICAL OFFICE

Laboratory Demographics

  • CLIA Code: 03D1067930
  • Facility Name: VIDAL MEDICAL OFFICE
  • Facility Address: 21300 N JOHN WAYNE PKWY STE 116
    MARICOPA, AZ
    ZIP 85139
  • Facility Phone: 520 423-9699
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HILDA FLORES-VIDAL MD
  • NPI Number: 1023112760
  • Taxonomy: 207QA0505X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D1067930
LAB Type Physician Office
Facility Name VIDAL MEDICAL OFFICE
Street 21300 N JOHN WAYNE PKWY STE 116
City MARICOPA
State AZ
ZIP 85139
Phone 520 423-9699
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/27/2025
Certificate Expiration Date 4/26/2027
Facility Type Physician Office
Lab Director HILDA FLORES-VIDAL MD

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