03D2269075 CLIA NUMBER - SUNRISE WELLNESS SOLUTION PLLC

Laboratory Demographics

  • CLIA Code: 03D2269075
  • Facility Name: SUNRISE WELLNESS SOLUTION PLLC
  • Facility Address: 5287 S HIGHWAY 95 STE I
    FORT MOHAVE, AZ
    ZIP 86426
  • Facility Phone: 928 234-1050
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: LISA A. STANLEY
  • NPI Number: 1407527203
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2269075
LAB Type Practitioner Other
Facility Name SUNRISE WELLNESS SOLUTION PLLC
Street 5287 S HIGHWAY 95 STE I
City FORT MOHAVE
State AZ
ZIP 86426
Phone 928 234-1050
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/20/2024
Certificate Expiration Date 9/19/2026
Facility Type Practitioner Other
Lab Director LISA A. STANLEY

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