03D0924212 CLIA NUMBER - HOSPICE OF HAVASU INC

Laboratory Demographics

  • CLIA Code: 03D0924212
  • Facility Name: HOSPICE OF HAVASU INC
  • Facility Address: 232 LONDON BRIDGE RD
    LAKE HAVASU, AZ
    ZIP 86403
  • Facility Phone: 928 453-2111
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: THERON TILGNER
  • NPI Number: 1649254517
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 03D0924212
LAB Type Hospice
Facility Name HOSPICE OF HAVASU INC
Street 232 LONDON BRIDGE RD
City LAKE HAVASU
State AZ
ZIP 86403
Phone 928 453-2111
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/22/2025
Certificate Expiration Date 1/21/2027
Facility Type Hospice
Lab Director THERON TILGNER

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