03D2043035 CLIA NUMBER - MI DOCTORA

Laboratory Demographics

  • CLIA Code: 03D2043035
  • Facility Name: MI DOCTORA
  • Facility Address: 1142 E SOUTHERN AVE, STE 101
    MESA, AZ
    ZIP 85204
  • Facility Phone: 480 821-3610
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: VIRGEN M. NIEVES
  • NPI Number: 1851707293
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 03D2043035
LAB Type Physician Office
Facility Name MI DOCTORA
Street 1142 E SOUTHERN AVE, STE 101
City MESA
State AZ
ZIP 85204
Phone 480 821-3610
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 6/26/2024
Certificate Expiration Date 6/25/2026
Facility Type Physician Office
Lab Director VIRGEN M. NIEVES

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