03D2199324 CLIA NUMBER - OPTIMAL HEALTH MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 03D2199324
  • Facility Name: OPTIMAL HEALTH MEDICAL CLINIC
  • Facility Address: 855 E BROWN RD, STE 10
    MESA, AZ
    ZIP 85203
  • Facility Phone: 623 910-3171
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: LILIAN L. LAIMO
  • NPI Number: 1710500962
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 03D2199324
LAB Type Practitioner Other
Facility Name OPTIMAL HEALTH MEDICAL CLINIC
Street 855 E BROWN RD, STE 10
City MESA
State AZ
ZIP 85203
Phone 623 910-3171
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/6/2024
Certificate Expiration Date 11/5/2026
Facility Type Practitioner Other
Lab Director LILIAN L. LAIMO

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This page was last updated on: 3/20/2025