45D2059338 CLIA NUMBER - MEDMARK TREATMENT CENTERS OF TEXAS, INC MEDMARK TREATMENT CENTERS CENTER

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Laboratory Demographics

CLIA Number: 45D2059338

Facility Name: MEDMARK TREATMENT CENTERS OF TEXAS, INC MEDMARK TREATMENT CENTERS CENTER

Facility Address:
1110 TENAHA STREET, SUITE 5
CENTER, TX
ZIP 75935
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Facility Phone Number: 936 598-6608

Facility Type: Other - OUTPATIENT TREATMENT

Certificate Type: Waiver

NPI Number: 1972955219

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2059338
LAB Type	Other - OUTPATIENT TREATMENT
Facility Name	MEDMARK TREATMENT CENTERS OF TEXAS, INC MEDMARK TREATMENT CENTERS CENTER
Street	1110 TENAHA STREET, SUITE 5
City	CENTER
State	TX
ZIP	75935
Phone	936 598-6608
CertificateType	4
CertificateEffectiveDate	5/21/2023
CertificateExpirationDate	5/20/2025
FacilityType	Waiver

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