03D2182125 CLIA NUMBER - EMBRY RIDDLE AERONAUTICAL UNIVERSITY

Laboratory Demographics

  • CLIA Code: 03D2182125
  • Facility Name: EMBRY RIDDLE AERONAUTICAL UNIVERSITY
  • Facility Address: 3700 WILLOW CREEK RD BLDG 73
    PRESCOTT, AZ
    ZIP 86301
  • Facility Phone: 928 777-6653
  • Facility Type: School/Student Health Service
  • Facility Type: Waiver
  • Lab Director: JORY JACOBS
  • NPI Number: 1104166727
  • Taxonomy: 208D00000X - General Practice

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 03D2182125
LAB Type School/Student Health Service
Facility Name EMBRY RIDDLE AERONAUTICAL UNIVERSITY
Street 3700 WILLOW CREEK RD BLDG 73
City PRESCOTT
State AZ
ZIP 86301
Phone 928 777-6653
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2024
Certificate Expiration Date 4/15/2026
Facility Type School/Student Health Service
Lab Director JORY JACOBS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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