03D2123969 CLIA NUMBER - MOHAVE NEPHROLOGY

Laboratory Demographics

  • CLIA Code: 03D2123969
  • Facility Name: MOHAVE NEPHROLOGY
  • Facility Address: 4263 HWY 68
    GOLDEN VALLEY, AZ
    ZIP 86413
  • Facility Phone: 928 715-6216
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VIJAYAVEL PALANICHAMY

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CLIA Record

Field Name Field Value
CLIA Number 03D2123969
LAB Type Physician Office
Facility Name MOHAVE NEPHROLOGY
Street 4263 HWY 68
City GOLDEN VALLEY
State AZ
ZIP 86413
Phone 928 715-6216
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/6/2025
Certificate Expiration Date 1/5/2027
Facility Type Physician Office
Lab Director VIJAYAVEL PALANICHAMY

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