05D1073599 CLIA NUMBER - HECTOR HEREDIA MD A PROF. CORP.

Laboratory Demographics

  • CLIA Code: 05D1073599
  • Facility Name: HECTOR HEREDIA MD A PROF. CORP.
  • Facility Address: 401 H ST, STE 2
    CHULA VISTA, CA
    ZIP 91910
  • Facility Phone: 619 420-1010
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HECTOR HEREDIA-MARTINEZ MD
  • NPI Number: 1699882365
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1073599
LAB Type Physician Office
Facility Name HECTOR HEREDIA MD A PROF. CORP.
Street 401 H ST, STE 2
City CHULA VISTA
State CA
ZIP 91910
Phone 619 420-1010
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/12/2025
Certificate Expiration Date 9/11/2027
Facility Type Physician Office
Lab Director HECTOR HEREDIA-MARTINEZ MD

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