03D1051453 CLIA NUMBER - AKDHC - LAKE HAVASU

Laboratory Demographics

  • CLIA Code: 03D1051453
  • Facility Name: AKDHC - LAKE HAVASU
  • Facility Address: 1851 MESQUITE AVE STE 216
    LAKE HAVASU CITY, AZ
    ZIP 86403
  • Facility Phone: 602 997-0484
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: WAYNE M. CUMBRIA
  • NPI Number: 1508055930
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D1051453
LAB Type Physician Office
Facility Name AKDHC - LAKE HAVASU
Street 1851 MESQUITE AVE STE 216
City LAKE HAVASU CITY
State AZ
ZIP 86403
Phone 602 997-0484
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 3/2/2024
Certificate Expiration Date 3/1/2026
Facility Type Physician Office
Lab Director WAYNE M. CUMBRIA

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