03D2026165 CLIA NUMBER - HAVASU REGIONAL MEDICAL CENTER WOUND CARE CENTER

Laboratory Demographics

  • CLIA Code: 03D2026165
  • Facility Name: HAVASU REGIONAL MEDICAL CENTER WOUND CARE CENTER
  • Facility Address: 1851 MESQUITE AVE SUITE 102
    LAKE HAVASU, AZ
    ZIP 86403
  • Facility Phone: 928 854-0037
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: HARRISON MCDONALD
  • NPI Number: 1245343482
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 03D2026165
LAB Type Ancillary Testing Site in Health Care Center
Facility Name HAVASU REGIONAL MEDICAL CENTER WOUND CARE CENTER
Street 1851 MESQUITE AVE SUITE 102
City LAKE HAVASU
State AZ
ZIP 86403
Phone 928 854-0037
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/24/2025
Certificate Expiration Date 6/23/2027
Facility Type Ancillary Testing Site in Health Care Center
Lab Director HARRISON MCDONALD

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