03D0925836 CLIA NUMBER - HAVEN OF LAKE HAVASU, LLC

Laboratory Demographics

  • CLIA Code: 03D0925836
  • Facility Name: HAVEN OF LAKE HAVASU, LLC
  • Facility Address: 2781 OSBORN DR
    LAKE HAVASU CITY, AZ
    ZIP 86406
  • Facility Phone: 928 505-5552
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: CHRISTINE WALLIN
  • NPI Number: 1366978603
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 03D0925836
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name HAVEN OF LAKE HAVASU, LLC
Street 2781 OSBORN DR
City LAKE HAVASU CITY
State AZ
ZIP 86406
Phone 928 505-5552
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/7/2025
Certificate Expiration Date 3/6/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director CHRISTINE WALLIN

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This page was last updated on: 6/4/2025