CLIA lab
CLIA 03D1012506: Hopi Wic Office of Health Services
Polacca, AZ. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 03D1012506 belongs to Hopi Wic Office of Health Services in Polacca, AZ.
Certificate of Waiver, effective October 23, 2024, expiration date October 22, 2026.
The CMS file posted October 16, 2026 lists the certificate as active, but its expiration date has passed. A renewal may not be in this file yet.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- October 23, 2024
- Certificate expiration
- October 22, 2026
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- May 12, 2003
- Facility type
- Other
- Ownership (control type)
- Government, other
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 03D1012506
- Lab name
- Hopi Wic Office of Health Services
- Address
- Mile Post 388, Highway 264, Polacca, AZ 86042
- Phone
- (928) 737-6361
- Fax
- (928) 737-6339
Annual test volume the lab reported
- Waived tests
- 570
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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Related
Questions
What is the CLIA number for Hopi Wic Office of Health Services in Polacca?
03D1012506, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Hopi Wic Office of Health Services hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 03D1012506 expire?
The CMS file lists October 22, 2026 as the certificate expiration date; the certificate took effect October 23, 2024.