45D2028458 CLIA NUMBER - TEXAS TREATMENT SERVICE, LLC

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Laboratory Demographics

CLIA Number: 45D2028458

Facility Name: TEXAS TREATMENT SERVICE, LLC

Facility Address:
4801 BRENTWOOD STAIR ROAD STE 404
FORT WORTH, TX
ZIP 76103
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Facility Phone Number: 817 492-9383

Facility Type: Other - OTP - MAT PROGRAM

Certificate Type: Waiver

NPI Number: 1932377082

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	45D2028458
LAB Type	Other - OTP - MAT PROGRAM
Facility Name	TEXAS TREATMENT SERVICE, LLC
Street	4801 BRENTWOOD STAIR ROAD STE 404
City	FORT WORTH
State	TX
ZIP	76103
Phone	817 492-9383
CertificateType	4
CertificateEffectiveDate	8/17/2023
CertificateExpirationDate	8/16/2025
FacilityType	Waiver

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