03D2115798 CLIA NUMBER - SOUTHWEST KIDNEY INSTITUTE

Laboratory Demographics

CLIA Number: 03D2115798

Facility Name: SOUTHWEST KIDNEY INSTITUTE

Facility Address:
2005 INJO DR, STE 103
LAKE HAVASU CITY, AZ
ZIP 86403
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Facility Phone Number: (480) 610-6100

Facility Type: PHYSICIAN OFFICE

Certificate Type: Microscopy

NPI Number: 1407139413

Taxonomy: 261QM0801X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D2115798
LAB Type	PHYSICIAN OFFICE
Facility Name	SOUTHWEST KIDNEY INSTITUTE
Street	2005 INJO DR, STE 103
City	LAKE HAVASU CITY
State	AZ
ZIP	86403
Phone	(480) 610-6100

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This page was last updated on: 5/11/2023