03D1067052 CLIA NUMBER - RYAN INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 03D1067052
  • Facility Name: RYAN INTERNAL MEDICINE
  • Facility Address: 1350 RIM DR
    FLAGSTAFF, AZ
    ZIP 86001
  • Facility Phone: 928 213-5881
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STACIE COLLINS
  • NPI Number: 1033225024
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D1067052
LAB Type Physician Office
Facility Name RYAN INTERNAL MEDICINE
Street 1350 RIM DR
City FLAGSTAFF
State AZ
ZIP 86001
Phone 928 213-5881
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/10/2025
Certificate Expiration Date 4/9/2027
Facility Type Physician Office
Lab Director STACIE COLLINS

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