03D1075749 CLIA NUMBER - NATIVIDAD VERDEJO DBA PACIFIC FAMILY MEDICINE

Laboratory Demographics

CLIA Number: 03D1075749

Facility Name: NATIVIDAD VERDEJO DBA PACIFIC FAMILY MEDICINE

Facility Address:
2360 W RAY RD SUITE #2
CHANDLER, AZ
ZIP 85224
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Facility Phone Number: 480 855-3770

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1396890612

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	03D1075749
LAB Type	Physician Office
Facility Name	NATIVIDAD VERDEJO DBA PACIFIC FAMILY MEDICINE
Street	2360 W RAY RD SUITE #2
City	CHANDLER
State	AZ
ZIP	85224
Phone	480 855-3770
CertificateType	4
CertificateEffectiveDate	10/26/2023
CertificateExpirationDate	10/25/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024