03D2262153 CLIA NUMBER - RIO RETREAT CENTER LLC

Laboratory Demographics

  • CLIA Code: 03D2262153
  • Facility Name: RIO RETREAT CENTER LLC
  • Facility Address: 1245 JACK BURDEN RD
    WICKENBURG, AZ
    ZIP 85390
  • Facility Phone: 928 212-8701
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: GEORGIA FOURLAS
  • NPI Number: 1821738865
  • Taxonomy: 261QM0850X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2262153
LAB Type Comp. Outpatient Rehab Facility
Facility Name RIO RETREAT CENTER LLC
Street 1245 JACK BURDEN RD
City WICKENBURG
State AZ
ZIP 85390
Phone 928 212-8701
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/9/2024
Certificate Expiration Date 6/8/2026
Facility Type Comp. Outpatient Rehab Facility
Lab Director GEORGIA FOURLAS

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