10D1051099 CLIA NUMBER - SUNRISE DETOXIFICATION CENTER LLC

Laboratory Demographics

CLIA Number: 10D1051099

Facility Name: SUNRISE DETOXIFICATION CENTER LLC

Facility Address:
3185 BOUTWELL RD
LAKE WORTH, FL
ZIP 33461
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Facility Phone Number: 561 533-0074

Facility Type: Other - DETOX CENTER

Certificate Type: Waiver

NPI Number: 1154484103

Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

CLIA Record

Field Name	Field Value
CLIA Number	10D1051099
LAB Type	Other - DETOX CENTER
Facility Name	SUNRISE DETOXIFICATION CENTER LLC
Street	3185 BOUTWELL RD
City	LAKE WORTH
State	FL
ZIP	33461
Phone	561 533-0074
CertificateType	4
CertificateEffectiveDate	2/22/2024
CertificateExpirationDate	2/21/2026
FacilityType	Waiver

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