03D2235223 CLIA NUMBER - FOOTHILLS ADULT CARE HOME

Laboratory Demographics

CLIA Number: 03D2235223

Facility Name: FOOTHILLS ADULT CARE HOME

Facility Address:
12447 S SANDRA AVE
YUMA, AZ
ZIP 85367
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Facility Phone Number: 928 305-8888

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1588025894

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	03D2235223
LAB Type	Assisted Living Facility
Facility Name	FOOTHILLS ADULT CARE HOME
Street	12447 S SANDRA AVE
City	YUMA
State	AZ
ZIP	85367
Phone	928 305-8888
CertificateType	4
CertificateEffectiveDate	9/7/2023
CertificateExpirationDate	9/6/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024