03D2175724 CLIA NUMBER - HOLDFAST RECOVERY

Laboratory Demographics

  • CLIA Code: 03D2175724
  • Facility Name: HOLDFAST RECOVERY
  • Facility Address: 1579 W GURLEY ST
    PRESCOTT, AZ
    ZIP 86305
  • Facility Phone: 928 231-1983
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: BRANDON MCDONOUGH
  • NPI Number: 1952807414
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 03D2175724
LAB Type Comp. Outpatient Rehab Facility
Facility Name HOLDFAST RECOVERY
Street 1579 W GURLEY ST
City PRESCOTT
State AZ
ZIP 86305
Phone 928 231-1983
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/27/2023
Certificate Expiration Date 11/26/2025
Facility Type Comp. Outpatient Rehab Facility
Lab Director BRANDON MCDONOUGH

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