14D2101029 CLIA NUMBER - BANYAN TREATMENT CENTER IL LLC

Laboratory Demographics

CLIA Number: 14D2101029

Facility Name: BANYAN TREATMENT CENTER IL LLC

Facility Address:
50 S MAIN ST, #290
NAPERVILLE, IL
ZIP 60540
Get Directions

Facility Phone Number: 954 533-7705

Facility Type: Other - SUBSTANCE ABUSE TRMT CTR

Certificate Type: Waiver

NPI Number: 1366811820

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	14D2101029
LAB Type	Other - SUBSTANCE ABUSE TRMT CTR
Facility Name	BANYAN TREATMENT CENTER IL LLC
Street	50 S MAIN ST, #290
City	NAPERVILLE
State	IL
ZIP	60540
Phone	954 533-7705
CertificateType	4
CertificateEffectiveDate	8/26/2023
CertificateExpirationDate	8/25/2025
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