03D2158892 CLIA NUMBER - GUARDIAN HOSPICE, LLC DBA ARIZONA LIFE HOSPICE - MOHAVE

Laboratory Demographics

  • CLIA Code: 03D2158892
  • Facility Name: GUARDIAN HOSPICE, LLC DBA ARIZONA LIFE HOSPICE - MOHAVE
  • Facility Address: 5225 HIGHWAY 95 STE 7
    FORT MOHAVE, AZ
    ZIP 86426
  • Facility Phone: 928 278-7691
  • Facility Type: Other - PALLIATIVE CARE AGENCY
  • Facility Type: Waiver
  • Lab Director: MARIA D. SALAMATIN
  • NPI Number: 1235631094
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 03D2158892
LAB Type Other - PALLIATIVE CARE AGENCY
Facility Name GUARDIAN HOSPICE, LLC DBA ARIZONA LIFE HOSPICE - MOHAVE
Street 5225 HIGHWAY 95 STE 7
City FORT MOHAVE
State AZ
ZIP 86426
Phone 928 278-7691
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/10/2024
Certificate Expiration Date 12/9/2026
Facility Type Other - PALLIATIVE CARE AGENCY
Lab Director MARIA D. SALAMATIN

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