45D2091040 CLIA NUMBER - ADDICTION CAMPUSES OF TEXAS DBA VERTAVA HEALTH OF TEXAS

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Laboratory Demographics

CLIA Number: 45D2091040

Facility Name: ADDICTION CAMPUSES OF TEXAS DBA VERTAVA HEALTH OF TEXAS

Facility Address:
6950 SHADY LANE
SCURRY, TX
ZIP 75158
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Facility Phone Number: 972 452-3182

Facility Type: Other - INPATIENT ADDICTION TREAT

Certificate Type: Waiver

NPI Number: 1477165660

Taxonomy: 2084A0401X - Psychiatry & Neurology
A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine

CLIA Record

Field Name	Field Value
CLIA Number	45D2091040
LAB Type	Other - INPATIENT ADDICTION TREAT
Facility Name	ADDICTION CAMPUSES OF TEXAS DBA VERTAVA HEALTH OF TEXAS
Street	6950 SHADY LANE
City	SCURRY
State	TX
ZIP	75158
Phone	972 452-3182
CertificateType	4
CertificateEffectiveDate	2/4/2023
CertificateExpirationDate	2/3/2025
FacilityType	Waiver

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