03D2119924 CLIA NUMBER - PAYSON OUTPATIENT SERVICE CENTER - 2

Laboratory Demographics

  • CLIA Code: 03D2119924
  • Facility Name: PAYSON OUTPATIENT SERVICE CENTER - 2
  • Facility Address: 803 W MAIN STREET
    PAYSON, AZ
    ZIP 85541
  • Facility Phone: 480 831-7566
  • Facility Type: Other - MENTAL HEALTH FACILITY
  • Facility Type: Waiver
  • Lab Director: EMILY KOCH
  • NPI Number: 1548416514
  • Taxonomy: 251S00000X - Community/Behavioral Health

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 03D2119924
LAB Type Other - MENTAL HEALTH FACILITY
Facility Name PAYSON OUTPATIENT SERVICE CENTER - 2
Street 803 W MAIN STREET
City PAYSON
State AZ
ZIP 85541
Phone 480 831-7566
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/6/2024
Certificate Expiration Date 10/5/2026
Facility Type Other - MENTAL HEALTH FACILITY
Lab Director EMILY KOCH

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