It is good to run the numbers, but the most important thing is to know the location you are looking at and what sales prices and rents the neighborhood can support.The price for this place is $272k and that is the short sale price, i have spoken to the agent and that is the best they can do.Rents are likely between $1200-$1300 per floor, no real need to improve the units as the neighborhood is unlikely to support higher rents at this time. 

Monthly cashflow improved by $150 from the debt restructure.  

With our first rental performing, we capitalized on the low property values with a newer home in foreclosure.

If you are talking about capex like a new roof, new flooring, or other major improvements then I would use the HELOC.You want to use the cash for more investments that will bring a return.

I had some comfort from my first 2 deals now that they were performing.

I only put the down payment and about 20k of capital improvements into it and have brought the income up 60% per month.

For the box size of the car wash you would need to see what rent per sq ft they are paying for the market and make sure it was not inflated with TI (tenant improvements) from the developer.

Additionally, how do you see Medical Offices as an asset class performing going forward?

-I performed a walk-through of the house to mark the 6 month mark and the place is immaculate.

Even a modest 10%-15%  discount will reduce your risk and increase ROI, as well as improve your cash flow numbers.