03D1022400 CLIA NUMBER - DR GUY GORMAN SR CARE HOME

Laboratory Demographics

  • CLIA Code: 03D1022400
  • Facility Name: DR GUY GORMAN SR CARE HOME
  • Facility Address: N HWY 191 HOSPITAL RD
    CHINLE, AZ
    ZIP 86503
  • Facility Phone: 928 674-5216
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ANGELA CLAW
  • NPI Number: 1770753543
  • Taxonomy: 311ZA0620X - Custodial Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 03D1022400
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name DR GUY GORMAN SR CARE HOME
Street N HWY 191 HOSPITAL RD
City CHINLE
State AZ
ZIP 86503
Phone 928 674-5216
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/17/2024
Certificate Expiration Date 2/16/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director ANGELA CLAW

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