03D1030139 CLIA NUMBER - LAKE MOHAVE RANCHO FIRE

Laboratory Demographics

  • CLIA Code: 03D1030139
  • Facility Name: LAKE MOHAVE RANCHO FIRE
  • Facility Address: 16126 PEARCE FERRY ROAD
    DOLAN SPRINGS, AZ
    ZIP 86441
  • Facility Phone: 928 767-3300
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: SHAUNA L. RAYMOND
  • NPI Number: 1861420929
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 03D1030139
LAB Type Ambulance
Facility Name LAKE MOHAVE RANCHO FIRE
Street 16126 PEARCE FERRY ROAD
City DOLAN SPRINGS
State AZ
ZIP 86441
Phone 928 767-3300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/31/2024
Certificate Expiration Date 8/30/2026
Facility Type Ambulance
Lab Director SHAUNA L. RAYMOND

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