03D2105028 CLIA NUMBER - SUMMIT BEHAVIORAL HEALTH OF ARIZONA

Laboratory Demographics

CLIA Number: 03D2105028

Facility Name: SUMMIT BEHAVIORAL HEALTH OF ARIZONA

Facility Address:
8705 EASTRIDGE DR
PRESCOTT VALLEY, AZ
ZIP 86314
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Facility Phone Number: (928) 231-2449

Facility Type: COMPREHENSIVE OUTPATIENT REHAB

Certificate Type: Waiver

NPI Number: 1023471646

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D2105028
LAB Type	COMPREHENSIVE OUTPATIENT REHAB
Facility Name	SUMMIT BEHAVIORAL HEALTH OF ARIZONA
Street	8705 EASTRIDGE DR
City	PRESCOTT VALLEY
State	AZ
ZIP	86314
Phone	(928) 231-2449

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This page was last updated on: 5/11/2023