03D2170991 CLIA NUMBER - COOK FAMILY PRACTICE, INC

Laboratory Demographics

  • CLIA Code: 03D2170991
  • Facility Name: COOK FAMILY PRACTICE, INC
  • Facility Address: 2331 HUALAPAI MOUNTAIN RD STE C
    KINGMAN, AZ
    ZIP 86401
  • Facility Phone: 928 565-6655
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: KARRIE A. COOK
  • NPI Number: 1497302988
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 03D2170991
LAB Type Practitioner Other
Facility Name COOK FAMILY PRACTICE, INC
Street 2331 HUALAPAI MOUNTAIN RD STE C
City KINGMAN
State AZ
ZIP 86401
Phone 928 565-6655
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/22/2025
Certificate Expiration Date 8/21/2027
Facility Type Practitioner Other
Lab Director KARRIE A. COOK

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