03D2189414 CLIA NUMBER - HAVEN OF PHOENIX

Laboratory Demographics

  • CLIA Code: 03D2189414
  • Facility Name: HAVEN OF PHOENIX
  • Facility Address: 4202 N 20TH AVE
    PHOENIX, AZ
    ZIP 85015
  • Facility Phone: 602 279-6234
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: BAHALEDIN AHMED
  • NPI Number: 1215383237
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 03D2189414
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name HAVEN OF PHOENIX
Street 4202 N 20TH AVE
City PHOENIX
State AZ
ZIP 85015
Phone 602 279-6234
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/30/2024
Certificate Expiration Date 7/29/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director BAHALEDIN AHMED

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