03D2274223 CLIA NUMBER - SAN CARLOS APACHE HEALTHCARE

Laboratory Demographics

  • CLIA Code: 03D2274223
  • Facility Name: SAN CARLOS APACHE HEALTHCARE
  • Facility Address: 102 MEDICINE WAY RD
    PERIDOT, AZ
    ZIP 85542
  • Facility Phone: 928 475-1203
  • Facility Type: Other - MOBILE HEALTH UNIT
  • Facility Type: Waiver
  • Lab Director: JAMES M. DARRAGH
  • NPI Number: 1538446166
  • Taxonomy: 282N00000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 03D2274223
LAB Type Other - MOBILE HEALTH UNIT
Facility Name SAN CARLOS APACHE HEALTHCARE
Street 102 MEDICINE WAY RD
City PERIDOT
State AZ
ZIP 85542
Phone 928 475-1203
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/28/2024
Certificate Expiration Date 12/27/2026
Facility Type Other - MOBILE HEALTH UNIT
Lab Director JAMES M. DARRAGH

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