03D2084554 CLIA NUMBER - CLINICA MEDICA HISPANA

Laboratory Demographics

  • CLIA Code: 03D2084554
  • Facility Name: CLINICA MEDICA HISPANA
  • Facility Address: 3140 N 35TH AVE STE 7
    PHOENIX, AZ
    ZIP 85017
  • Facility Phone: 602 353-6656
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: FRANCISCO J. HERNANDEZ
  • NPI Number: 1982031795
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 03D2084554
LAB Type Physician Office
Facility Name CLINICA MEDICA HISPANA
Street 3140 N 35TH AVE STE 7
City PHOENIX
State AZ
ZIP 85017
Phone 602 353-6656
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/17/2024
Certificate Expiration Date 12/16/2026
Facility Type Physician Office
Lab Director FRANCISCO J. HERNANDEZ

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