03D2143433 CLIA NUMBER - MOHAVE NEPHROLOGY

Laboratory Demographics

  • CLIA Code: 03D2143433
  • Facility Name: MOHAVE NEPHROLOGY
  • Facility Address: 3535 E ANDY DEVINE AVE
    KINGMAN, AZ
    ZIP 86401
  • Facility Phone: 928 757-2050
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VIJAYAVEL PALANICHAMY
  • NPI Number: 1669798823
  • Taxonomy: 207RN0300X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 03D2143433
LAB Type Physician Office
Facility Name MOHAVE NEPHROLOGY
Street 3535 E ANDY DEVINE AVE
City KINGMAN
State AZ
ZIP 86401
Phone 928 757-2050
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/30/2024
Certificate Expiration Date 1/29/2026
Facility Type Physician Office
Lab Director VIJAYAVEL PALANICHAMY

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: 9/29/2025