10D2167854 CLIA NUMBER - GUEST HOUSE OUTPATIENT RECOVERY LLC

Laboratory Demographics

CLIA Number: 10D2167854

Facility Name: GUEST HOUSE OUTPATIENT RECOVERY LLC

Facility Address:
2233 E FORT KING ST SUITE A
OCALA, FL
ZIP 34471
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Facility Phone Number: 855 483-7800

Facility Type: Other - SAMH OUTPATIENT FACILITY

Certificate Type: Waiver

NPI Number: 1295374940

Taxonomy: 261QM0850X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

CLIA Record

Field Name	Field Value
CLIA Number	10D2167854
LAB Type	Other - SAMH OUTPATIENT FACILITY
Facility Name	GUEST HOUSE OUTPATIENT RECOVERY LLC
Street	2233 E FORT KING ST SUITE A
City	OCALA
State	FL
ZIP	34471
Phone	855 483-7800
CertificateType	4
CertificateEffectiveDate	6/17/2023
CertificateExpirationDate	6/16/2025
FacilityType	Waiver

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