05D1036276 CLIA NUMBER - MARTIN ROCHA MD INC

Laboratory Demographics

  • CLIA Code: 05D1036276
  • Facility Name: MARTIN ROCHA MD INC
  • Facility Address: 29099 HOSPITAL RD STE 204-A
    LAKE ARROWHEAD, CA
    ZIP 92352
  • Facility Phone: 909 336-3670
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARTIN L. ROCHA MD
  • NPI Number: 1962435586
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D1036276
LAB Type Physician Office
Facility Name MARTIN ROCHA MD INC
Street 29099 HOSPITAL RD STE 204-A
City LAKE ARROWHEAD
State CA
ZIP 92352
Phone 909 336-3670
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/17/2024
Certificate Expiration Date 4/16/2026
Facility Type Physician Office
Lab Director MARTIN L. ROCHA MD

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