03D2159160 CLIA NUMBER - EMBARK RECOVERY, LLC

Laboratory Demographics

  • CLIA Code: 03D2159160
  • Facility Name: EMBARK RECOVERY, LLC
  • Facility Address: 1118 WILLOW CREEK RD
    PRESCOTT, AZ
    ZIP 86301
  • Facility Phone: 623 256-4184
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: PAUL VALBUENA
  • NPI Number: 1184193963
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 03D2159160
LAB Type Comp. Outpatient Rehab Facility
Facility Name EMBARK RECOVERY, LLC
Street 1118 WILLOW CREEK RD
City PRESCOTT
State AZ
ZIP 86301
Phone 623 256-4184
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/12/2024
Certificate Expiration Date 12/11/2026
Facility Type Comp. Outpatient Rehab Facility
Lab Director PAUL VALBUENA

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