03D2170166 CLIA NUMBER - ROYAL AZ LLC

Laboratory Demographics

  • CLIA Code: 03D2170166
  • Facility Name: ROYAL AZ LLC
  • Facility Address: 822 W GURLEY ST
    PRESCOTT, AZ
    ZIP 86305
  • Facility Phone: 561 562-6269
  • Facility Type: Other - SUBSTANCE ABUSE TREATMENT
  • Facility Type: Waiver
  • Lab Director: LISA A. TOMSAK
  • NPI Number: 1811449721
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 03D2170166
LAB Type Other - SUBSTANCE ABUSE TREATMENT
Facility Name ROYAL AZ LLC
Street 822 W GURLEY ST
City PRESCOTT
State AZ
ZIP 86305
Phone 561 562-6269
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/5/2025
Certificate Expiration Date 8/4/2027
Facility Type Other - SUBSTANCE ABUSE TREATMENT
Lab Director LISA A. TOMSAK

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