03D2204190 CLIA NUMBER - DESERT HAVEN HOME CARE LLC

Laboratory Demographics

  • CLIA Code: 03D2204190
  • Facility Name: DESERT HAVEN HOME CARE LLC
  • Facility Address: 4123 N 21ST ST
    PHOENIX, AZ
    ZIP 85016
  • Facility Phone: 602 670-9326
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER ZAMBAKERI
  • NPI Number: 1376149070
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 03D2204190
LAB Type Assisted Living Facility
Facility Name DESERT HAVEN HOME CARE LLC
Street 4123 N 21ST ST
City PHOENIX
State AZ
ZIP 85016
Phone 602 670-9326
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/8/2024
Certificate Expiration Date 12/7/2026
Facility Type Assisted Living Facility
Lab Director CHRISTOPHER ZAMBAKERI

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