03D0721884 CLIA NUMBER - APACHE COUNTY PUBLIC HEALTH SERVICES DISTRICT

Laboratory Demographics

CLIA Number: 03D0721884

Facility Name: APACHE COUNTY PUBLIC HEALTH SERVICES DISTRICT

Facility Address:
323 S MOUNTAIN AVE
SPRINGERVILLE, AZ
ZIP 85938
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Facility Phone Number: 928 522-9574

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1821321035

Taxonomy: 251K00000X - Public Health or Welfare

CLIA Record

Field Name	Field Value
CLIA Number	03D0721884
LAB Type	Other
Facility Name	APACHE COUNTY PUBLIC HEALTH SERVICES DISTRICT
Street	323 S MOUNTAIN AVE
City	SPRINGERVILLE
State	AZ
ZIP	85938
Phone	928 522-9574
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