15D2244788 CLIA NUMBER - HAPPY JOYOUS & FREE RECOVERY LIFE COACHING

Laboratory Demographics

CLIA Number: 15D2244788

Facility Name: HAPPY JOYOUS & FREE RECOVERY LIFE COACHING

Facility Address:
214 4TH ST
COVINGTON, IN
ZIP 47932
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Facility Phone Number: 765 585-5060

Facility Type: Comp. Outpatient Rehab Facility

Certificate Type: Waiver

NPI Number: 1235712811

Taxonomy: 261QM0801X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	15D2244788
LAB Type	Comp. Outpatient Rehab Facility
Facility Name	HAPPY JOYOUS & FREE RECOVERY LIFE COACHING
Street	214 4TH ST
City	COVINGTON
State	IN
ZIP	47932
Phone	765 585-5060
CertificateType	4
CertificateEffectiveDate	12/6/2023
CertificateExpirationDate	12/5/2025
FacilityType	Waiver

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