05D0991868 CLIA NUMBER - THEODORE AFFUE, MD INC

Laboratory Demographics

  • CLIA Code: 05D0991868
  • Facility Name: THEODORE AFFUE, MD INC
  • Facility Address: 2061 ROSS AVENUE, SUITE #A
    EL CENTRO, CA
    ZIP 92243
  • Facility Phone: 760 353-8181
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: THEODORE AFFUE MD
  • NPI Number: 1386674000
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 05D0991868
LAB Type Physician Office
Facility Name THEODORE AFFUE, MD INC
Street 2061 ROSS AVENUE, SUITE #A
City EL CENTRO
State CA
ZIP 92243
Phone 760 353-8181
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 3/1/2024
Certificate Expiration Date 2/28/2026
Facility Type Physician Office
Lab Director THEODORE AFFUE MD

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