03D0667776 CLIA NUMBER - GREENLEE COUNTY HEALTH DEPARTMENT

Laboratory Demographics

CLIA Number: 03D0667776

Facility Name: GREENLEE COUNTY HEALTH DEPARTMENT

Facility Address:
PO BOX 936/FIFTH AND LEONARD
CLIFTON, AZ
ZIP 85533
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Facility Phone Number: 928 865-2601

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1730310046

Taxonomy: 261QP0905X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D0667776
LAB Type	Home Health Agency
Facility Name	GREENLEE COUNTY HEALTH DEPARTMENT
Street	PO BOX 936/FIFTH AND LEONARD
City	CLIFTON
State	AZ
ZIP	85533
Phone	928 865-2601
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024