03D2116017 CLIA NUMBER - VILLA TEJADA LLC DBA HOLY CROSS HOSPICE

Laboratory Demographics

  • CLIA Code: 03D2116017
  • Facility Name: VILLA TEJADA LLC DBA HOLY CROSS HOSPICE
  • Facility Address: 1103 S MESA DR
    MESA, AZ
    ZIP 85210
  • Facility Phone: 480 718-5678
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: EVA LORANE T. WARD
  • NPI Number: 1386097905
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 03D2116017
LAB Type Hospice
Facility Name VILLA TEJADA LLC DBA HOLY CROSS HOSPICE
Street 1103 S MESA DR
City MESA
State AZ
ZIP 85210
Phone 480 718-5678
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/18/2024
Certificate Expiration Date 7/17/2026
Facility Type Hospice
Lab Director EVA LORANE T. WARD

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