03D2106391 CLIA NUMBER - DIVINE FAMILY CARE GLENDALE

Laboratory Demographics

  • CLIA Code: 03D2106391
  • Facility Name: DIVINE FAMILY CARE GLENDALE
  • Facility Address: 5125 W MYRTLE AVE
    GLENDALE, AZ
    ZIP 85301
  • Facility Phone: 956 407-6889
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DIEGO NARANJO
  • NPI Number: 1376921106
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 03D2106391
LAB Type Physician Office
Facility Name DIVINE FAMILY CARE GLENDALE
Street 5125 W MYRTLE AVE
City GLENDALE
State AZ
ZIP 85301
Phone 956 407-6889
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/17/2023
Certificate Expiration Date 12/16/2025
Facility Type Physician Office
Lab Director DIEGO NARANJO

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