03D1106728 CLIA NUMBER - AKDHC - FLAGSTAFF

Laboratory Demographics

  • CLIA Code: 03D1106728
  • Facility Name: AKDHC - FLAGSTAFF
  • Facility Address: 2201 N VICKEY STREET SUITE 110
    FLAGSTAFF, AZ
    ZIP 86004
  • Facility Phone: 928 649-7997
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PETE LEOPOLD
  • NPI Number: 1053500488
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D1106728
LAB Type Physician Office
Facility Name AKDHC - FLAGSTAFF
Street 2201 N VICKEY STREET SUITE 110
City FLAGSTAFF
State AZ
ZIP 86004
Phone 928 649-7997
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/3/2025
Certificate Expiration Date 5/2/2027
Facility Type Physician Office
Lab Director PETE LEOPOLD

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