03D1029374 CLIA NUMBER - HOLBROOK EMS, INC

Laboratory Demographics

  • CLIA Code: 03D1029374
  • Facility Name: HOLBROOK EMS, INC
  • Facility Address: 30 W VISTA DRIVE
    HOLBROOK, AZ
    ZIP 86025
  • Facility Phone: 928 524-2190
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: TIM HAWMAN
  • NPI Number: 1780610063
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 03D1029374
LAB Type Ambulance
Facility Name HOLBROOK EMS, INC
Street 30 W VISTA DRIVE
City HOLBROOK
State AZ
ZIP 86025
Phone 928 524-2190
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/16/2024
Certificate Expiration Date 8/15/2026
Facility Type Ambulance
Lab Director TIM HAWMAN

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