03D2049669 CLIA NUMBER - MT GRAHAM OB/GYN

Laboratory Demographics

  • CLIA Code: 03D2049669
  • Facility Name: MT GRAHAM OB/GYN
  • Facility Address: 2175 W 16TH ST STE E
    SAFFORD, AZ
    ZIP 85546
  • Facility Phone: 928 424-4444
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DOUGLAS G. HARRISON
  • NPI Number: 1720065253
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 03D2049669
LAB Type Physician Office
Facility Name MT GRAHAM OB/GYN
Street 2175 W 16TH ST STE E
City SAFFORD
State AZ
ZIP 85546
Phone 928 424-4444
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/12/2024
Certificate Expiration Date 8/11/2026
Facility Type Physician Office
Lab Director DOUGLAS G. HARRISON

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