03D2271941 CLIA NUMBER - SCOTTSDALE RECOVERY II LLC OP STE A

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Laboratory Demographics

CLIA Number: 03D2271941

Facility Name: SCOTTSDALE RECOVERY II LLC OP STE A

Facility Address:
8149 N 87TH PL STE A
SCOTTSDALE, AZ
ZIP 85258
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Facility Phone Number: 480 699-9044

Facility Type: Other - OUTPATIENT ASAM

Certificate Type: Waiver

NPI Number: 1407578180

Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

CLIA Record

Field Name	Field Value
CLIA Number	03D2271941
LAB Type	Other - OUTPATIENT ASAM
Facility Name	SCOTTSDALE RECOVERY II LLC OP STE A
Street	8149 N 87TH PL STE A
City	SCOTTSDALE
State	AZ
ZIP	85258
Phone	480 699-9044
CertificateType	4
CertificateEffectiveDate	11/10/2022
CertificateExpirationDate	11/9/2024
FacilityType	Waiver

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