03D2106068 CLIA NUMBER - FOUR PEAKS HEALTHCARE ASSOCIATES, PLLC

Laboratory Demographics

  • CLIA Code: 03D2106068
  • Facility Name: FOUR PEAKS HEALTHCARE ASSOCIATES, PLLC
  • Facility Address: 1515 E CEDAR AVE, SUITE C1
    FLAGSTAFF, AZ
    ZIP 86004
  • Facility Phone: 928 773-9714
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: THERESA G. DOWELL
  • NPI Number: 1720450232
  • Taxonomy: 261QP2300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 03D2106068
LAB Type Practitioner Other
Facility Name FOUR PEAKS HEALTHCARE ASSOCIATES, PLLC
Street 1515 E CEDAR AVE, SUITE C1
City FLAGSTAFF
State AZ
ZIP 86004
Phone 928 773-9714
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/9/2023
Certificate Expiration Date 12/8/2025
Facility Type Practitioner Other
Lab Director THERESA G. DOWELL

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: 6/4/2025