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General NPI Number Information
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NPI Number | 1134072713
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Entity Type | Organization
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Legal Business Name | CLINICAL DX OF MESA LLC
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Dates
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Enumeration Date | 02/16/2026
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Last Update Date | 02/16/2026
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Provider Practice Location Address
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Address Line | 840 W UNIVERSITY DR STE 6
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City | MESA
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State | AZ
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Zip | 85201-5529
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Country | US
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Telephone | 213-476-9779
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Fax |
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Provider Business Mailing Address
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Address Line | 840 W UNIVERSITY DR STE 6
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City | MESA
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State | AZ
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Zip | 85201-5529
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTOPHER ROMAN CORONA
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Credential |
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Telephone | 213-476-9779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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