03D2301847 CLIA NUMBER - GENESIS HEALTH, LLC

Laboratory Demographics

  • CLIA Code: 03D2301847
  • Facility Name: GENESIS HEALTH, LLC
  • Facility Address: 2055 HWY 95
    BULLHEAD CITY, AZ
    ZIP 86442
  • Facility Phone: 928 299-8482
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NICHOLAS STAGG
  • NPI Number: 1942069661
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 03D2301847
LAB Type Physician Office
Facility Name GENESIS HEALTH, LLC
Street 2055 HWY 95
City BULLHEAD CITY
State AZ
ZIP 86442
Phone 928 299-8482
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/2/2024
Certificate Expiration Date 4/1/2026
Facility Type Physician Office
Lab Director NICHOLAS STAGG

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This page was last updated on: 6/4/2025