03D2257956 CLIA NUMBER - MINGUS MOUNTAIN PRIMARY CARE, PLLC

Laboratory Demographics

  • CLIA Code: 03D2257956
  • Facility Name: MINGUS MOUNTAIN PRIMARY CARE, PLLC
  • Facility Address: 450 S WILLARD ST STE 107
    COTTONWOOD, AZ
    ZIP 86326
  • Facility Phone: 928 649-6080
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL A. ARANDA
  • NPI Number: 1245991785
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D2257956
LAB Type Physician Office
Facility Name MINGUS MOUNTAIN PRIMARY CARE, PLLC
Street 450 S WILLARD ST STE 107
City COTTONWOOD
State AZ
ZIP 86326
Phone 928 649-6080
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/13/2024
Certificate Expiration Date 4/12/2026
Facility Type Physician Office
Lab Director MICHAEL A. ARANDA

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