03D2185281 CLIA NUMBER - MAGGIES LAB CAB, LLC

Laboratory Demographics

  • CLIA Code: 03D2185281
  • Facility Name: MAGGIES LAB CAB, LLC
  • Facility Address: 2150 MCCULLOCH BLVD N UNIT B
    LAKE HAVASU CITY, AZ
    ZIP 86403
  • Facility Phone: 928 486-3989
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: ANDRES ALVARADO
  • NPI Number: 1598425076
  • Taxonomy: 207ZP0105X - Pathology

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CLIA Record

Field Name Field Value
CLIA Number 03D2185281
LAB Type Mobile Laboratory
Facility Name MAGGIES LAB CAB, LLC
Street 2150 MCCULLOCH BLVD N UNIT B
City LAKE HAVASU CITY
State AZ
ZIP 86403
Phone 928 486-3989
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/2/2024
Certificate Expiration Date 6/1/2026
Facility Type Mobile Laboratory
Lab Director ANDRES ALVARADO

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