03D2045161 CLIA NUMBER - COPPER CREEK INN

Laboratory Demographics

  • CLIA Code: 03D2045161
  • Facility Name: COPPER CREEK INN
  • Facility Address: 2200 W FAIRVIEW STREET
    CHANDLER, AZ
    ZIP 85224
  • Facility Phone: 480 634-4191
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: NAOMI HARTMANN
  • NPI Number: 1932479946
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 03D2045161
LAB Type Assisted Living Facility
Facility Name COPPER CREEK INN
Street 2200 W FAIRVIEW STREET
City CHANDLER
State AZ
ZIP 85224
Phone 480 634-4191
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/8/2024
Certificate Expiration Date 8/7/2026
Facility Type Assisted Living Facility
Lab Director NAOMI HARTMANN

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