03D2048475 CLIA NUMBER - COPPER HILLS AID OPCO LLC DBA COPPER HILLS HOUSE

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Laboratory Demographics

CLIA Number: 03D2048475

Facility Name: COPPER HILLS AID OPCO LLC DBA COPPER HILLS HOUSE

Facility Address:
12234 E N FRONTAGE RD
YUMA, AZ
ZIP 85367
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Facility Phone Number: 928 305-0892

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1922124494

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	03D2048475
LAB Type	Assisted Living Facility
Facility Name	COPPER HILLS AID OPCO LLC DBA COPPER HILLS HOUSE
Street	12234 E N FRONTAGE RD
City	YUMA
State	AZ
ZIP	85367
Phone	928 305-0892
CertificateType	4
CertificateEffectiveDate	10/16/2022
CertificateExpirationDate	10/15/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024