CLIA lab
CLIA 03D1079849: Bouse Medical Clinic
Bouse, AZ. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 03D1079849 belongs to Bouse Medical Clinic in Bouse, AZ.
Certificate of Waiver, effective February 7, 2026, expires February 6, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
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
- February 7, 2026
- Certificate expiration
- February 6, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- February 7, 2008
- Facility type
- Community clinic
- Ownership (control type)
- Private
- 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
- 03D1079849
- Lab name
- Bouse Medical Clinic
- Address
- 44031 E Plomosa Rd, Bouse, AZ 85325
- Phone
- (928) 851-2177
- Fax
- (928) 851-1828
Annual test volume the lab reported
- Waived tests
- 100
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Related
Questions
What is the CLIA number for Bouse Medical Clinic in Bouse?
03D1079849, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Bouse Medical Clinic hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 03D1079849 expire?
The CMS file lists February 6, 2028 as the certificate expiration date; the certificate took effect February 7, 2026.