03D2254707 CLIA NUMBER - CAMELBACK RECOVERY TREATMENT CENTER

Laboratory Demographics

  • CLIA Code: 03D2254707
  • Facility Name: CAMELBACK RECOVERY TREATMENT CENTER
  • Facility Address: 4527 N 16TH ST STE 200
    PHOENIX, AZ
    ZIP 85016
  • Facility Phone: 480 721-0443
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: MICHAEL VINES
  • NPI Number: 1952944738
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2254707
LAB Type Comp. Outpatient Rehab Facility
Facility Name CAMELBACK RECOVERY TREATMENT CENTER
Street 4527 N 16TH ST STE 200
City PHOENIX
State AZ
ZIP 85016
Phone 480 721-0443
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/7/2024
Certificate Expiration Date 3/6/2026
Facility Type Comp. Outpatient Rehab Facility
Lab Director MICHAEL VINES

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