10D2238091 CLIA NUMBER - BOCA COVE DETOX LLC

Laboratory Demographics

CLIA Number: 10D2238091

Facility Name: BOCA COVE DETOX LLC

Facility Address:
899 MEADOWS RD
BOCA RATON, FL
ZIP 33486
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Facility Phone Number: 561 228-3771

Facility Type: Other - TREATMENT CENTER/ DRUG AN

Certificate Type: Waiver

NPI Number: 1275112393

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2238091
LAB Type	Other - TREATMENT CENTER/ DRUG AN
Facility Name	BOCA COVE DETOX LLC
Street	899 MEADOWS RD
City	BOCA RATON
State	FL
ZIP	33486
Phone	561 228-3771
CertificateType	4
CertificateEffectiveDate	9/30/2023
CertificateExpirationDate	9/29/2025
FacilityType	Waiver

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