03D2327165 CLIA NUMBER - WHITERIVER IHS DEPARTMENT OF PREVENTATIVE MEDICINE

Laboratory Demographics

  • CLIA Code: 03D2327165
  • Facility Name: WHITERIVER IHS DEPARTMENT OF PREVENTATIVE MEDICINE
  • Facility Address: 200 W HOSPITAL DR
    WHITERIVER, AZ
    ZIP 85941
  • Facility Phone: 928 338-3738
  • Facility Type: Health Fair
  • Facility Type: Waiver
  • Lab Director: TRAVIS AUSTIN
  • NPI Number: 1205161817
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 03D2327165
LAB Type Health Fair
Facility Name WHITERIVER IHS DEPARTMENT OF PREVENTATIVE MEDICINE
Street 200 W HOSPITAL DR
City WHITERIVER
State AZ
ZIP 85941
Phone 928 338-3738
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/17/2025
Certificate Expiration Date 7/16/2027
Facility Type Health Fair
Lab Director TRAVIS AUSTIN

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