10D2270145 CLIA NUMBER - URP LAKE WORTH, LLC

Laboratory Demographics

CLIA Number: 10D2270145

Facility Name: URP LAKE WORTH, LLC

Facility Address:
4865 40TH WAY S
LAKE WORTH, FL
ZIP 33466
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Facility Phone Number: 954 654-9072

Facility Type: Other - SUBSTANCE ABUSE TREATMENT

Certificate Type: Waiver

NPI Number: 1326780883

Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

CLIA Record

Field Name	Field Value
CLIA Number	10D2270145
LAB Type	Other - SUBSTANCE ABUSE TREATMENT
Facility Name	URP LAKE WORTH, LLC
Street	4865 40TH WAY S
City	LAKE WORTH
State	FL
ZIP	33466
Phone	954 654-9072
CertificateType	4
CertificateEffectiveDate	10/11/2022
CertificateExpirationDate	10/10/2024
FacilityType	Waiver

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