44D2202107 CLIA NUMBER - MIDDLE TENNESSEE TREATMENT CENTERS LLC DBA CLEVELAND CTC

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Laboratory Demographics

CLIA Number: 44D2202107

Facility Name: MIDDLE TENNESSEE TREATMENT CENTERS LLC DBA CLEVELAND CTC

Facility Address:
3575 KEITH STREET NW
CLEVELAND, TN
ZIP 37312
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Facility Phone Number: 401 862-0522

Facility Type: Comp. Outpatient Rehab Facility

Certificate Type: Waiver

NPI Number: 1366041196

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	44D2202107
LAB Type	Comp. Outpatient Rehab Facility
Facility Name	MIDDLE TENNESSEE TREATMENT CENTERS LLC DBA CLEVELAND CTC
Street	3575 KEITH STREET NW
City	CLEVELAND
State	TN
ZIP	37312
Phone	401 862-0522
CertificateType	4
CertificateEffectiveDate	11/24/2022
CertificateExpirationDate	11/23/2024
FacilityType	Waiver

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