03D2291835 CLIA NUMBER - BEACON CHARITIES, DBA BEACON TREATMENT CENTER

Laboratory Demographics

  • CLIA Code: 03D2291835
  • Facility Name: BEACON CHARITIES, DBA BEACON TREATMENT CENTER
  • Facility Address: 30 ACR 3398
    VERNON, AZ
    ZIP 85940
  • Facility Phone: 928 251-2785
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: JAMES K. APPLEGATE
  • NPI Number: 1578229613
  • Taxonomy: 261QR0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2291835
LAB Type Comp. Outpatient Rehab Facility
Facility Name BEACON CHARITIES, DBA BEACON TREATMENT CENTER
Street 30 ACR 3398
City VERNON
State AZ
ZIP 85940
Phone 928 251-2785
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/17/2025
Certificate Expiration Date 10/16/2027
Facility Type Comp. Outpatient Rehab Facility
Lab Director JAMES K. APPLEGATE

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