03D2297330 CLIA NUMBER - KINGMAN BEHAVIORAL HEALTH

Laboratory Demographics

  • CLIA Code: 03D2297330
  • Facility Name: KINGMAN BEHAVIORAL HEALTH
  • Facility Address: 1031 DETROIT AVE
    KINGMAN, AZ
    ZIP 86401
  • Facility Phone: 928 582-2116
  • Facility Type: Other - RESIDENTIAL SA TRTMT
  • Facility Type: Waiver
  • Lab Director: KEVIN BROWN
  • NPI Number: 1275375891
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 03D2297330
LAB Type Other - RESIDENTIAL SA TRTMT
Facility Name KINGMAN BEHAVIORAL HEALTH
Street 1031 DETROIT AVE
City KINGMAN
State AZ
ZIP 86401
Phone 928 582-2116
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/16/2024
Certificate Expiration Date 1/15/2026
Facility Type Other - RESIDENTIAL SA TRTMT
Lab Director KEVIN BROWN

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