03D2048476 CLIA NUMBER - LAKE HAVASU AL, LLC DBA AVISTA SENIOR LIVING LAKE HAVASU

Laboratory Demographics

  • CLIA Code: 03D2048476
  • Facility Name: LAKE HAVASU AL, LLC DBA AVISTA SENIOR LIVING LAKE HAVASU
  • Facility Address: 3076 SHOSHONE DRIVE
    LAKE HAVASU CITY, AZ
    ZIP 86406
  • Facility Phone: 928 680-1701
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: SCOTT CHRISTIANSEN
  • NPI Number: 1790812436
  • Taxonomy: 310400000X - Assisted Living Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 03D2048476
LAB Type Assisted Living Facility
Facility Name LAKE HAVASU AL, LLC DBA AVISTA SENIOR LIVING LAKE HAVASU
Street 3076 SHOSHONE DRIVE
City LAKE HAVASU CITY
State AZ
ZIP 86406
Phone 928 680-1701
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/16/2024
Certificate Expiration Date 10/15/2026
Facility Type Assisted Living Facility
Lab Director SCOTT CHRISTIANSEN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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