06D2167237 CLIA NUMBER - E DAWN MARTIN CACIII, LLC DBA - RECOVERY UNLIMITED

Laboratory Demographics

CLIA Number: 06D2167237

Facility Name: E DAWN MARTIN CACIII, LLC DBA - RECOVERY UNLIMITED

Facility Address:
1702 E PIKES PEAK AVE
COLORADO SPRINGS, CO
ZIP 80909
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Facility Phone Number: 719 358-7338

Facility Type: Other - CLINICAL PRACTITIONER

Certificate Type: Waiver

NPI Number: 1205326428

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	06D2167237
LAB Type	Other - CLINICAL PRACTITIONER
Facility Name	E DAWN MARTIN CACIII, LLC DBA - RECOVERY UNLIMITED
Street	1702 E PIKES PEAK AVE
City	COLORADO SPRINGS
State	CO
ZIP	80909
Phone	719 358-7338
CertificateType	4
CertificateEffectiveDate	1/28/2023
CertificateExpirationDate	1/27/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024