03D2297245 CLIA NUMBER - AGAVE RIDGE BEHAVIORAL HOSPITAL

Laboratory Demographics

  • CLIA Code: 03D2297245
  • Facility Name: AGAVE RIDGE BEHAVIORAL HOSPITAL
  • Facility Address: 3322 S ELLSWORTH RD
    MESA, AZ
    ZIP 85212
  • Facility Phone: 844 715-1100
  • Facility Type: Hospital
  • Facility Type: Waiver
  • Lab Director: NATHAN A. JONES
  • NPI Number: 1013789668
  • Taxonomy: 283Q00000X - Psychiatric Hospital

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CLIA Record

Field Name Field Value
CLIA Number 03D2297245
LAB Type Hospital
Facility Name AGAVE RIDGE BEHAVIORAL HOSPITAL
Street 3322 S ELLSWORTH RD
City MESA
State AZ
ZIP 85212
Phone 844 715-1100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/12/2024
Certificate Expiration Date 1/11/2026
Facility Type Hospital
Lab Director NATHAN A. JONES

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