Healther Providers Data Logo

03D2056703 CLIA NUMBER - NORTHERN ARIZONA MEDICAL GROUP - FLAGSTAFF

Laboratory Demographics

CLIA Number: 03D2056703

Facility Name: NORTHERN ARIZONA MEDICAL GROUP - FLAGSTAFF

Facility Address:
107 E OAK AVE STE 201
FLAGSTAFF, AZ
ZIP 86001
Get Directions

Facility Phone Number: 928 913-8800

Facility Type: Physician Office

Certificate Type: Microscopy
NPI Number: 1174983621

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

CLIA Record

Field Name Field Value
CLIA Number 03D2056703
LAB Type Physician Office
Facility Name NORTHERN ARIZONA MEDICAL GROUP - FLAGSTAFF
Street 107 E OAK AVE STE 201
City FLAGSTAFF
State AZ
ZIP 86001
Phone 928 913-8800
CertificateType 3
CertificateEffectiveDate 4/2/2023
CertificateExpirationDate 4/1/2025
FacilityType PPMP

Download Record

Download this CLIA NUMBER record in Text format: Export

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

Download this CLIA NUMBER record in XML format: Export

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