03D0972134 CLIA NUMBER - GREASEWOOD RURAL HEALTH CLINIC

Laboratory Demographics

  • CLIA Code: 03D0972134
  • Facility Name: GREASEWOOD RURAL HEALTH CLINIC
  • Facility Address: OFF ROUTE 15
    GREASEWOOD, AZ
    ZIP 86505
  • Facility Phone: 928 755-4916
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: KENNETH ANAEME
  • NPI Number: 1013134832
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D0972134
LAB Type Rural Health Clinic
Facility Name GREASEWOOD RURAL HEALTH CLINIC
Street OFF ROUTE 15
City GREASEWOOD
State AZ
ZIP 86505
Phone 928 755-4916
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/19/2024
Certificate Expiration Date 1/18/2026
Facility Type Rural Health Clinic
Lab Director KENNETH ANAEME

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