39D2074417 CLIA NUMBER - STR ADDICTION COUNSELING

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Laboratory Demographics

CLIA Number: 39D2074417

Facility Name: STR ADDICTION COUNSELING

Facility Address:
1400 VETERANS HWY
LEVITTOWN, PA
ZIP 19056
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Facility Phone Number: 267 244-1107

Facility Type: Comp. Outpatient Rehab Facility

Certificate Type: Waiver

NPI Number: 1275964991

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	39D2074417
LAB Type	Comp. Outpatient Rehab Facility
Facility Name	STR ADDICTION COUNSELING
Street	1400 VETERANS HWY
City	LEVITTOWN
State	PA
ZIP	19056
Phone	267 244-1107
CertificateType	4
CertificateEffectiveDate	3/10/2024
CertificateExpirationDate	3/9/2026
FacilityType	Waiver

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