04D2178524 CLIA NUMBER - TRUE SELF RECOVERY

Laboratory Demographics

  • CLIA Code: 04D2178524
  • Facility Name: TRUE SELF RECOVERY
  • Facility Address: 1104 2ND STREET
    ROGERS, AR
    ZIP 72756
  • Facility Phone: 949 973-5427
  • Facility Type: Other - OUTPATIENT BEHAVIORAL HEA
  • Facility Type: Waiver
  • Lab Director: CHEYNE R. LEICHTAMER
  • NPI Number: 1285273219
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2178524
LAB Type Other - OUTPATIENT BEHAVIORAL HEA
Facility Name TRUE SELF RECOVERY
Street 1104 2ND STREET
City ROGERS
State AR
ZIP 72756
Phone 949 973-5427
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/4/2024
Certificate Expiration Date 2/3/2026
Facility Type Other - OUTPATIENT BEHAVIORAL HEA
Lab Director CHEYNE R. LEICHTAMER

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