45D2070123 CLIA NUMBER - PHOENIX HOUSES OF TEXAS, INC

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Laboratory Demographics

CLIA Number: 45D2070123

Facility Name: PHOENIX HOUSES OF TEXAS, INC

Facility Address:
1910 PACIFIC AVE SUITE 10-500
DALLAS, TX
ZIP 75201
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Facility Phone Number: 214 885-0131

Facility Type: Other - SUBSTANCE ABUSE TREATMENT

Certificate Type: Waiver

NPI Number: 1508992249

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2070123
LAB Type	Other - SUBSTANCE ABUSE TREATMENT
Facility Name	PHOENIX HOUSES OF TEXAS, INC
Street	1910 PACIFIC AVE SUITE 10-500
City	DALLAS
State	TX
ZIP	75201
Phone	214 885-0131
CertificateType	4
CertificateEffectiveDate	12/10/2023
CertificateExpirationDate	12/9/2025
FacilityType	Waiver

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