CLIA lab
CLIA 03D2194967: Countryside Living
Queen Creek, AZ. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 03D2194967 belongs to Countryside Living in Queen Creek, AZ.
Certificate of Waiver, effective October 5, 2024, expiration date October 4, 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 5, 2024
- Certificate expiration
- October 4, 2026
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- October 5, 2020
- Facility type
- Assisted living facility
- 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
- 03D2194967
- Lab name
- Countryside Living
- Address
- 22773 E Ocotillo Rd, Queen Creek, AZ 85142
- Phone
- (602) 962-0505
- Fax
- (480) 987-1124
Annual test volume the lab reported
- Waived tests
- 50
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Banner Physician Specialists Arizona LLCCertificate for Provider-Performed Microscopy Procedures, Physician office03D2106649
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- Banner Physician Super Specialists Arizona LLCCertificate of Waiver, Physician office03D2217366
Related
Questions
What is the CLIA number for Countryside Living in Queen Creek?
03D2194967, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Countryside Living hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 03D2194967 expire?
The CMS file lists October 4, 2026 as the certificate expiration date; the certificate took effect October 5, 2024.