03D2205307 CLIA NUMBER - TONTO APACHE HEALTH CARE

Laboratory Demographics

  • CLIA Code: 03D2205307
  • Facility Name: TONTO APACHE HEALTH CARE
  • Facility Address: BIA 101 STE 40
    PAYSON, AZ
    ZIP 85541
  • Facility Phone: 928 472-3906
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JESSIE BALCOM
  • NPI Number: 1447843651
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2205307
LAB Type Physician Office
Facility Name TONTO APACHE HEALTH CARE
Street BIA 101 STE 40
City PAYSON
State AZ
ZIP 85541
Phone 928 472-3906
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/1/2024
Certificate Expiration Date 9/30/2026
Facility Type Physician Office
Lab Director JESSIE BALCOM

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