03D2110923 CLIA NUMBER - Lhcg Lxxvii, LLC Dba Northern Arizona

Laboratory Demographics

CLIA Number: 03D2110923

Facility Name: Lhcg Lxxvii, LLC Dba Northern Arizona

Facility Address:
203 S Candy Lane, Ste 5a
Cottonwood, AZ
ZIP 86326
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Facility Phone Number: (928) 639-6674

Facility Type: HOME HEALTH AGENCY

Certificate Type: Waiver

NPI Number: 1356702104

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	03D2110923
LAB Type	HOME HEALTH AGENCY
Facility Name	Lhcg Lxxvii, LLC Dba Northern Arizona
Street	203 S Candy Lane, Ste 5a
City	Cottonwood
State	AZ
ZIP	86326
Phone	(928) 639-6674

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This page was last updated on: 4/7/2021