66D0675978 CLIA NUMBER - LUCIA CHIANG VILLAGOMEZ ARIZAPA HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 66D0675978
  • Facility Name: LUCIA CHIANG VILLAGOMEZ ARIZAPA HEALTH CENTER
  • Facility Address: PO BOX 520446 SAN JOSE VILLAGE
    TINIAN, MP
    ZIP 96952
  • Facility Phone: 670 433-9263
  • Facility Type: Rural Health Clinic
  • Facility Type: Certificate of Compliance
  • Lab Director: PHILIP D. DAUTERMAN
  • NPI Number: 1568083459
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 66D0675978
LAB Type Rural Health Clinic
Facility Name LUCIA CHIANG VILLAGOMEZ ARIZAPA HEALTH CENTER
Street PO BOX 520446 SAN JOSE VILLAGE
City TINIAN
State MP
ZIP 96952
Phone 670 433-9263
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 12/12/2024
Certificate Expiration Date 12/11/2026
Facility Type Rural Health Clinic
Lab Director PHILIP D. DAUTERMAN

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