10D2110099 CLIA NUMBER - EBB TIDE TREATMENT CENTER

Laboratory Demographics

  • CLIA Code: 10D2110099
  • Facility Name: EBB TIDE TREATMENT CENTER
  • Facility Address: 400 EXECUTIVE CENTER DRIVE SUITE 209
    WEST PALM BEACH, FL
    ZIP 33401
  • Facility Phone: 844 430-4357
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: CHRISTINE DEPAOLIS
  • NPI Number: 1699135186
  • Taxonomy: 261QM0850X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2110099
LAB Type Comp. Outpatient Rehab Facility
Facility Name EBB TIDE TREATMENT CENTER
Street 400 EXECUTIVE CENTER DRIVE SUITE 209
City WEST PALM BEACH
State FL
ZIP 33401
Phone 844 430-4357
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/8/2024
Certificate Expiration Date 3/7/2026
Facility Type Comp. Outpatient Rehab Facility
Lab Director CHRISTINE DEPAOLIS

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This page was last updated on: 9/29/2025