03D2130100 CLIA NUMBER - MOUNTAIN VALLEY HOME FOR HEALTH

Laboratory Demographics

  • CLIA Code: 03D2130100
  • Facility Name: MOUNTAIN VALLEY HOME FOR HEALTH
  • Facility Address: 3700 N WINDSONG DRIVE
    PRESCOTT VALLEY, AZ
    ZIP 86314
  • Facility Phone: 928 775-7888
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: PATRICK MAHANEY
  • NPI Number: 1780179044
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2130100
LAB Type Home Health Agency
Facility Name MOUNTAIN VALLEY HOME FOR HEALTH
Street 3700 N WINDSONG DRIVE
City PRESCOTT VALLEY
State AZ
ZIP 86314
Phone 928 775-7888
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/2/2025
Certificate Expiration Date 5/1/2027
Facility Type Home Health Agency
Lab Director PATRICK MAHANEY

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This page was last updated on: 6/4/2025