03D2129251 CLIA NUMBER - SOUL SURGERY LLC

Laboratory Demographics

CLIA Number: 03D2129251

Facility Name: SOUL SURGERY LLC

Facility Address:
14362 N FRANK LLOYD WRIGHT BLVD
SCOTTSDALE, AZ
ZIP 85260
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Facility Phone Number: (480) 912-3105

Facility Type: OTHER

Certificate Type: Waiver

NPI Number: 1871026674

Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

CLIA Record

Field Name	Field Value
CLIA Number	03D2129251
LAB Type	OTHER
Facility Name	SOUL SURGERY LLC
Street	14362 N FRANK LLOYD WRIGHT BLVD
City	SCOTTSDALE
State	AZ
ZIP	85260
Phone	(480) 912-3105

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