03D2176101 CLIA NUMBER - TERRY SMITH FAMILY HEALTHCARE, PLLC

Laboratory Demographics

  • CLIA Code: 03D2176101
  • Facility Name: TERRY SMITH FAMILY HEALTHCARE, PLLC
  • Facility Address: 1016 W UNIVERSITY AVE, SUITE 206
    FLAGSTAFF, AZ
    ZIP 86001
  • Facility Phone: 928 266-1530
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TERRY E. SMITH
  • NPI Number: 1477960987
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 03D2176101
LAB Type Physician Office
Facility Name TERRY SMITH FAMILY HEALTHCARE, PLLC
Street 1016 W UNIVERSITY AVE, SUITE 206
City FLAGSTAFF
State AZ
ZIP 86001
Phone 928 266-1530
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/9/2023
Certificate Expiration Date 12/8/2025
Facility Type Physician Office
Lab Director TERRY E. SMITH

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