03D2110927 CLIA NUMBER - LHCG LXXVII, LLC DBA NORTHERN ARIZONA HOSPICE

Laboratory Demographics

  • CLIA Code: 03D2110927
  • Facility Name: LHCG LXXVII, LLC DBA NORTHERN ARIZONA HOSPICE
  • Facility Address: 203 S CANDY LANE, STE 2A
    COTTONWOOD, AZ
    ZIP 86326
  • Facility Phone: 928 639-6676
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: CAROL DURKALEC
  • NPI Number: 1164882619
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 03D2110927
LAB Type Hospice
Facility Name LHCG LXXVII, LLC DBA NORTHERN ARIZONA HOSPICE
Street 203 S CANDY LANE, STE 2A
City COTTONWOOD
State AZ
ZIP 86326
Phone 928 639-6676
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/28/2024
Certificate Expiration Date 3/27/2026
Facility Type Hospice
Lab Director CAROL DURKALEC

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This page was last updated on: 3/20/2025