10D2073558 CLIA NUMBER - LIGHTHOUSE RECOVERY INSTITUTE

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Laboratory Demographics

CLIA Number: 10D2073558

Facility Name: LIGHTHOUSE RECOVERY INSTITUTE

Facility Address:
1609 S CONGRESS AVE
BOYNTON BEACH, FL
ZIP 33426
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Facility Phone Number: 609 238-4467

Facility Type: Other - IOP TREATMENT CENTER

Certificate Type: Waiver

NPI Number: 1619305562

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2073558
LAB Type	Other - IOP TREATMENT CENTER
Facility Name	LIGHTHOUSE RECOVERY INSTITUTE
Street	1609 S CONGRESS AVE
City	BOYNTON BEACH
State	FL
ZIP	33426
Phone	609 238-4467
CertificateType	4
CertificateEffectiveDate	2/20/2024
CertificateExpirationDate	2/19/2026
FacilityType	Waiver

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