03D2124326 CLIA NUMBER - COPPER QUEEN COMMUNITY HOSPITAL ED DEPARTMENT DOUGLAS

Laboratory Demographics

  • CLIA Code: 03D2124326
  • Facility Name: COPPER QUEEN COMMUNITY HOSPITAL ED DEPARTMENT DOUGLAS
  • Facility Address: 100 E 5TH ST
    DOUGLAS, AZ
    ZIP 85607
  • Facility Phone: 520 432-6587
  • Facility Type: Other - FREESTANDING ER
  • Facility Type: Certificate of Compliance
  • Lab Director: MAX MIROT
  • NPI Number: 1942217088
  • Taxonomy: 261Q00000X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 03D2124326
LAB Type Other - FREESTANDING ER
Facility Name COPPER QUEEN COMMUNITY HOSPITAL ED DEPARTMENT DOUGLAS
Street 100 E 5TH ST
City DOUGLAS
State AZ
ZIP 85607
Phone 520 432-6587
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 6/21/2024
Certificate Expiration Date 6/20/2026
Facility Type Other - FREESTANDING ER
Lab Director MAX MIROT

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