03D2319792 CLIA NUMBER - SOBER MOUNTAIN

Laboratory Demographics

  • CLIA Code: 03D2319792
  • Facility Name: SOBER MOUNTAIN
  • Facility Address: 580 E OLD LINDEN RD STE 7
    SHOW LOW, AZ
    ZIP 85901
  • Facility Phone: 928 537-4346
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: BRIAN MERRILL
  • NPI Number: 1356051122
  • Taxonomy: 261QR0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2319792
LAB Type Comp. Outpatient Rehab Facility
Facility Name SOBER MOUNTAIN
Street 580 E OLD LINDEN RD STE 7
City SHOW LOW
State AZ
ZIP 85901
Phone 928 537-4346
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/7/2025
Certificate Expiration Date 3/6/2027
Facility Type Comp. Outpatient Rehab Facility
Lab Director BRIAN MERRILL

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