44D2221218 CLIA NUMBER - APPLEGATE HEALTH SERVICES OF TENNESSEE, INC DBA APPLEGATE RECOVERY DICKSON

Laboratory Demographics

CLIA Number: 44D2221218

Facility Name: APPLEGATE HEALTH SERVICES OF TENNESSEE, INC DBA APPLEGATE RECOVERY DICKSON

Facility Address:
3205A TN-46
DICKSON, TN
ZIP 37055
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Facility Phone Number: 214 379-3300

Facility Type: Other - OUTPATIENT ADULT ADDICTIO

Certificate Type: Waiver

NPI Number: 1447851175

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	44D2221218
LAB Type	Other - OUTPATIENT ADULT ADDICTIO
Facility Name	APPLEGATE HEALTH SERVICES OF TENNESSEE, INC DBA APPLEGATE RECOVERY DICKSON
Street	3205A TN-46
City	DICKSON
State	TN
ZIP	37055
Phone	214 379-3300
CertificateType	4
CertificateEffectiveDate	4/20/2023
CertificateExpirationDate	4/19/2025
FacilityType	Waiver

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