03D2139869 CLIA NUMBER - SEDONA WELLNESS RETREAT

Laboratory Demographics

  • CLIA Code: 03D2139869
  • Facility Name: SEDONA WELLNESS RETREAT
  • Facility Address: 125 KALLOF PL
    SEDONA, AZ
    ZIP 86336
  • Facility Phone: 928 239-4589
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RYAN D. FERCHOFF
  • NPI Number: 1780084236
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2139869
LAB Type Physician Office
Facility Name SEDONA WELLNESS RETREAT
Street 125 KALLOF PL
City SEDONA
State AZ
ZIP 86336
Phone 928 239-4589
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2023
Certificate Expiration Date 11/8/2025
Facility Type Physician Office
Lab Director RYAN D. FERCHOFF

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This page was last updated on: 9/29/2025