10D2157455 CLIA NUMBER - HOLISTIX TREATMENT CENTERS

Laboratory Demographics

CLIA Number: 10D2157455

Facility Name: HOLISTIX TREATMENT CENTERS

Facility Address:
9935 PALOMINO DRIVE
LAKE WORTH, FL
ZIP 33467
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Facility Phone Number: 561 802-7158

Facility Type: Other - DETOX TX CTR

Certificate Type: Waiver

NPI Number: 1114498565

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2157455
LAB Type	Other - DETOX TX CTR
Facility Name	HOLISTIX TREATMENT CENTERS
Street	9935 PALOMINO DRIVE
City	LAKE WORTH
State	FL
ZIP	33467
Phone	561 802-7158
CertificateType	4
CertificateEffectiveDate	11/6/2022
CertificateExpirationDate	11/5/2024
FacilityType	Waiver

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