10D2141887 CLIA NUMBER - BEACHSIDE DETOX

Laboratory Demographics

CLIA Number: 10D2141887

Facility Name: BEACHSIDE DETOX

Facility Address:
1101 54TH STREET
WEST PALM BEACH, FL
ZIP 33407
Get Directions

Facility Phone Number: 772 252-1125

Facility Type: Other - INPATIENT DETOX

Certificate Type: Waiver

NPI Number: 1477974806

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2141887
LAB Type	Other - INPATIENT DETOX
Facility Name	BEACHSIDE DETOX
Street	1101 54TH STREET
City	WEST PALM BEACH
State	FL
ZIP	33407
Phone	772 252-1125
CertificateType	4
CertificateEffectiveDate	12/26/2023
CertificateExpirationDate	12/25/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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