03D2309227 CLIA NUMBER - ACADEMIC HEALTH IN DBA ACADEMIC URGENT CARE

Laboratory Demographics

  • CLIA Code: 03D2309227
  • Facility Name: ACADEMIC HEALTH IN DBA ACADEMIC URGENT CARE
  • Facility Address: 1510 E WAGON WHEEL LN STE 104
    FORT MOHAVE, AZ
    ZIP 86426
  • Facility Phone: 928 889-2273
  • Facility Type: Other - URGENT CARE
  • Facility Type: Waiver
  • Lab Director: SCOTT HAVENS
  • NPI Number: 1285452516
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2309227
LAB Type Other - URGENT CARE
Facility Name ACADEMIC HEALTH IN DBA ACADEMIC URGENT CARE
Street 1510 E WAGON WHEEL LN STE 104
City FORT MOHAVE
State AZ
ZIP 86426
Phone 928 889-2273
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/12/2024
Certificate Expiration Date 8/11/2026
Facility Type Other - URGENT CARE
Lab Director SCOTT HAVENS

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