05D2100475 CLIA NUMBER - CEDAR POINT RECOVERY LLC

Laboratory Demographics

CLIA Number: 05D2100475

Facility Name: CEDAR POINT RECOVERY LLC

Facility Address:
8950 CAL CENTER DR STE 160
SACRAMENTO, CA
ZIP 95826
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Facility Phone Number: 914 960-0080

Facility Type: Other - DRUG & ALCOHOL DETOX FA

Certificate Type: Waiver

NPI Number: 1790164143

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2100475
LAB Type	Other - DRUG & ALCOHOL DETOX FA
Facility Name	CEDAR POINT RECOVERY LLC
Street	8950 CAL CENTER DR STE 160
City	SACRAMENTO
State	CA
ZIP	95826
Phone	914 960-0080
CertificateType	4
CertificateEffectiveDate	8/14/2023
CertificateExpirationDate	8/13/2025
FacilityType	Waiver

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