03D2278096 CLIA NUMBER - DOUGLAS - ACUTE CARE CLINIC

Laboratory Demographics

  • CLIA Code: 03D2278096
  • Facility Name: DOUGLAS - ACUTE CARE CLINIC
  • Facility Address: 1111 F AVE
    DOUGLAS, AZ
    ZIP 85607
  • Facility Phone: 520 364-1429
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: DARLENE MELK
  • NPI Number: 1760589204
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2278096
LAB Type Federally Qualified Health Center
Facility Name DOUGLAS - ACUTE CARE CLINIC
Street 1111 F AVE
City DOUGLAS
State AZ
ZIP 85607
Phone 520 364-1429
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/10/2025
Certificate Expiration Date 3/9/2027
Facility Type Federally Qualified Health Center
Lab Director DARLENE MELK

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