03D2113737 CLIA NUMBER - SCOTTSDALE PROVIDENCE RECOVERY CENTER

Laboratory Demographics

CLIA Number: 03D2113737

Facility Name: SCOTTSDALE PROVIDENCE RECOVERY CENTER

Facility Address:
8889 E VIA LINDA BLVD
SCOTTSDALE, AZ
ZIP 85258
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Facility Phone Number: (480) 284-7440

Facility Type: COMPREHENSIVE OUTPATIENT REHAB

Certificate Type: Waiver

NPI Number: 1023523396

Taxonomy: 261QD0000X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D2113737
LAB Type	COMPREHENSIVE OUTPATIENT REHAB
Facility Name	SCOTTSDALE PROVIDENCE RECOVERY CENTER
Street	8889 E VIA LINDA BLVD
City	SCOTTSDALE
State	AZ
ZIP	85258
Phone	(480) 284-7440

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