25D2085264 CLIA NUMBER - ALTERNATIVE FOR LIFE TREATMENT AND RECOVERY

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Laboratory Demographics

CLIA Number: 25D2085264

Facility Name: ALTERNATIVE FOR LIFE TREATMENT AND RECOVERY

Facility Address:
5360 I-55 N STE 160
JACKSON, MS
ZIP 39211
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Facility Phone Number: 601 362-3131

Facility Type: Other - DRUG TREATMENT

Certificate Type: Waiver

NPI Number: 1821248279

Taxonomy: 261QM2800X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.

CLIA Record

Field Name	Field Value
CLIA Number	25D2085264
LAB Type	Other - DRUG TREATMENT
Facility Name	ALTERNATIVE FOR LIFE TREATMENT AND RECOVERY
Street	5360 I-55 N STE 160
City	JACKSON
State	MS
ZIP	39211
Phone	601 362-3131
CertificateType	4
CertificateEffectiveDate	10/9/2022
CertificateExpirationDate	10/8/2024
FacilityType	Waiver

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