CLIA lab
CLIA 03D2170991: Cook Family Practice, Inc
Kingman, AZ. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 03D2170991 belongs to Cook Family Practice, Inc in Kingman, AZ.
Certificate of Waiver, effective August 22, 2025, expires August 21, 2027.
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
- August 22, 2025
- Certificate expiration
- August 21, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- August 22, 2019
- Facility type
- Other practitioner
- Ownership (control type)
- Proprietary
- 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
- 03D2170991
- Lab name
- Cook Family Practice, Inc
- Address
- 2331 Hualapai Mountain Rd Ste C, Kingman, AZ 86401
- Phone
- (928) 565-6655
- Fax
- (928) 565-6578
Annual test volume the lab reported
- Waived tests
- 500
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Avista Senior Living White CliffsCertificate of Waiver, Assisted living facility03D2119988
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Related
Questions
What is the CLIA number for Cook Family Practice, Inc in Kingman?
03D2170991, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Cook Family Practice, Inc hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 03D2170991 expire?
The CMS file lists August 21, 2027 as the certificate expiration date; the certificate took effect August 22, 2025.