03D2240265 CLIA NUMBER - WOLF CREEK RECOVERY

Laboratory Demographics

  • CLIA Code: 03D2240265
  • Facility Name: WOLF CREEK RECOVERY
  • Facility Address: 600 E GURLEY ST STE B & C
    PRESCOTT, AZ
    ZIP 86301
  • Facility Phone: 928 732-0169
  • Facility Type: Other - BEH HEALTH
  • Facility Type: Waiver
  • Lab Director: SHEILA K. BUSCH
  • NPI Number: 1699348557
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 03D2240265
LAB Type Other - BEH HEALTH
Facility Name WOLF CREEK RECOVERY
Street 600 E GURLEY ST STE B & C
City PRESCOTT
State AZ
ZIP 86301
Phone 928 732-0169
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/18/2023
Certificate Expiration Date 10/17/2025
Facility Type Other - BEH HEALTH
Lab Director SHEILA K. BUSCH

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