03D2210700 CLIA NUMBER - RIVERSIDE PHARMACY

Laboratory Demographics

  • CLIA Code: 03D2210700
  • Facility Name: RIVERSIDE PHARMACY
  • Facility Address: 2410 HIGHWAY 95
    BULLHEAD CITY, AZ
    ZIP 86442
  • Facility Phone: 928 219-4700
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SATHISH A. CARIAPPA
  • NPI Number: 1356961726
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2210700
LAB Type Pharmacy
Facility Name RIVERSIDE PHARMACY
Street 2410 HIGHWAY 95
City BULLHEAD CITY
State AZ
ZIP 86442
Phone 928 219-4700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/22/2025
Certificate Expiration Date 1/21/2027
Facility Type Pharmacy
Lab Director SATHISH A. CARIAPPA

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