03D2136798 CLIA NUMBER - COPPER CANYON FIRE & MEDICAL DISTRICT

Laboratory Demographics

  • CLIA Code: 03D2136798
  • Facility Name: COPPER CANYON FIRE & MEDICAL DISTRICT
  • Facility Address: 26B W SALT MINE RD
    CAMP VERDE, AZ
    ZIP 86322
  • Facility Phone: 928 567-9401
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: TERRY KELLER
  • NPI Number: 1932624392
  • Taxonomy: 341600000X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 03D2136798
LAB Type Ambulance
Facility Name COPPER CANYON FIRE & MEDICAL DISTRICT
Street 26B W SALT MINE RD
City CAMP VERDE
State AZ
ZIP 86322
Phone 928 567-9401
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/15/2023
Certificate Expiration Date 9/14/2025
Facility Type Ambulance
Lab Director TERRY KELLER

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