03D2210807 CLIA NUMBER - VERDE VALLEY ASSISTED LIVING

Laboratory Demographics

CLIA Number: 03D2210807

Facility Name: VERDE VALLEY ASSISTED LIVING

Facility Address:
195 WILLARD ST
COTTONWOOD, AZ
ZIP 86326
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Facility Phone Number: 928 634-4278

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1104976265

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	03D2210807
LAB Type	Assisted Living Facility
Facility Name	VERDE VALLEY ASSISTED LIVING
Street	195 WILLARD ST
City	COTTONWOOD
State	AZ
ZIP	86326
Phone	928 634-4278
CertificateType	4
CertificateEffectiveDate	1/25/2023
CertificateExpirationDate	1/24/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024