03D0879910 CLIA NUMBER - SNOWFLAKE MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 03D0879910
  • Facility Name: SNOWFLAKE MEDICAL CENTER
  • Facility Address: 590 S MAIN STREET
    SNOWFLAKE, AZ
    ZIP 85937
  • Facility Phone: 928 536-7519
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. RANDAL SHUMWAY
  • NPI Number: 1144291915
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D0879910
LAB Type Physician Office
Facility Name SNOWFLAKE MEDICAL CENTER
Street 590 S MAIN STREET
City SNOWFLAKE
State AZ
ZIP 85937
Phone 928 536-7519
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/10/2025
Certificate Expiration Date 5/9/2027
Facility Type Physician Office
Lab Director DR. RANDAL SHUMWAY

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