03D0990779 CLIA NUMBER - COLORADO RIVER PEDIATRICS

Laboratory Demographics

  • CLIA Code: 03D0990779
  • Facility Name: COLORADO RIVER PEDIATRICS
  • Facility Address: 1611 JOY LANE STE 2
    FORT MOHAVE, AZ
    ZIP 86426
  • Facility Phone: 928 788-8000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALAN J. BARTON MD
  • NPI Number: 1235410077
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 03D0990779
LAB Type Physician Office
Facility Name COLORADO RIVER PEDIATRICS
Street 1611 JOY LANE STE 2
City FORT MOHAVE
State AZ
ZIP 86426
Phone 928 788-8000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/31/2025
Certificate Expiration Date 8/30/2027
Facility Type Physician Office
Lab Director ALAN J. BARTON MD

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