03D2266064 CLIA NUMBER - LIVING WATERS HOSPICE

Laboratory Demographics

  • CLIA Code: 03D2266064
  • Facility Name: LIVING WATERS HOSPICE
  • Facility Address: 3711 HIGHWAY 68
    GOLDEN VALLEY, AZ
    ZIP 86413
  • Facility Phone: 928 565-9000
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: JOHN A. WEIDNER
  • NPI Number: 1922366947
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 03D2266064
LAB Type Hospice
Facility Name LIVING WATERS HOSPICE
Street 3711 HIGHWAY 68
City GOLDEN VALLEY
State AZ
ZIP 86413
Phone 928 565-9000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/4/2024
Certificate Expiration Date 8/3/2026
Facility Type Hospice
Lab Director JOHN A. WEIDNER

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