03D2143743 CLIA NUMBER - COMPREHENSIVE INTERVENTIONAL CARE CENTERS DBA COMPREHENSIVE INTEGRATED CARE

Laboratory Demographics

  • CLIA Code: 03D2143743
  • Facility Name: COMPREHENSIVE INTERVENTIONAL CARE CENTERS DBA COMPREHENSIVE INTEGRATED CARE
  • Facility Address: 2301 N 4TH STREET
    FLAGSTAFF, AZ
    ZIP 86004
  • Facility Phone: 928 719-7400
  • Facility Type: Other - OFFICE BASED LAB
  • Facility Type: Waiver
  • Lab Director: KEVIN DUWE
  • NPI Number: 1235616152
  • Taxonomy: 2085R0204X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 03D2143743
LAB Type Other - OFFICE BASED LAB
Facility Name COMPREHENSIVE INTERVENTIONAL CARE CENTERS DBA COMPREHENSIVE INTEGRATED CARE
Street 2301 N 4TH STREET
City FLAGSTAFF
State AZ
ZIP 86004
Phone 928 719-7400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/5/2024
Certificate Expiration Date 2/4/2026
Facility Type Other - OFFICE BASED LAB
Lab Director KEVIN DUWE

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This page was last updated on: 9/29/2025