46D2037588 CLIA NUMBER - ACTION RECOVERY GROUP

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Laboratory Demographics

CLIA Number: 46D2037588

Facility Name: ACTION RECOVERY GROUP

Facility Address:
1708 EAST 5550 SOUTH #23
OGDEN, UT
ZIP 84403
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Facility Phone Number: 801 475-4673

Facility Type: Comp. Outpatient Rehab Facility

Certificate Type: Waiver

NPI Number: 1386913895

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	46D2037588
LAB Type	Comp. Outpatient Rehab Facility
Facility Name	ACTION RECOVERY GROUP
Street	1708 EAST 5550 SOUTH #23
City	OGDEN
State	UT
ZIP	84403
Phone	801 475-4673
CertificateType	4
CertificateEffectiveDate	3/14/2023
CertificateExpirationDate	3/13/2025
FacilityType	Waiver

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