22D2244360 CLIA NUMBER - MASSACHUSETTS DETOX CENTERS, INC

Laboratory Demographics

CLIA Number: 22D2244360

Facility Name: MASSACHUSETTS DETOX CENTERS, INC

Facility Address:
362 MIDDLESEX AVENUE
WILMINGTON, MA
ZIP 01887
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Facility Phone Number: 978 471-8124

Facility Type: Other - SUBSTANCE ABUSE TREATMENT

Certificate Type: Waiver

NPI Number: 1699442475

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	22D2244360
LAB Type	Other - SUBSTANCE ABUSE TREATMENT
Facility Name	MASSACHUSETTS DETOX CENTERS, INC
Street	362 MIDDLESEX AVENUE
City	WILMINGTON
State	MA
ZIP	01887
Phone	978 471-8124
CertificateType	4
CertificateEffectiveDate	12/1/2023
CertificateExpirationDate	11/30/2025
FacilityType	Waiver

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