03D2030502 CLIA NUMBER - LAHODAS PLLC DBA MERCY GRACE PRIVATE PRACTICE

Laboratory Demographics

  • CLIA Code: 03D2030502
  • Facility Name: LAHODAS PLLC DBA MERCY GRACE PRIVATE PRACTICE
  • Facility Address: 1720 E BOSTON ST, STE 101
    GILBERT, AZ
    ZIP 85295
  • Facility Phone: 480 745-3702
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HOPE M. IJAOLA
  • NPI Number: 1225462468
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2030502
LAB Type Physician Office
Facility Name LAHODAS PLLC DBA MERCY GRACE PRIVATE PRACTICE
Street 1720 E BOSTON ST, STE 101
City GILBERT
State AZ
ZIP 85295
Phone 480 745-3702
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/28/2025
Certificate Expiration Date 9/27/2027
Facility Type Physician Office
Lab Director HOPE M. IJAOLA

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