45D2096522 CLIA NUMBER - AAC DALLAS OUTPATIENT CENTER, LLC DBA GREENHOUSE OUTPATIENT CENTER

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Laboratory Demographics

CLIA Number: 45D2096522

Facility Name: AAC DALLAS OUTPATIENT CENTER, LLC DBA GREENHOUSE OUTPATIENT CENTER

Facility Address:
2301 AVENUE J
ARLINGTON, TX
ZIP 76006
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Facility Phone Number: 817 649-3821

Facility Type: Comp. Outpatient Rehab Facility

Certificate Type: Waiver

NPI Number: 1104212794

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2096522
LAB Type	Comp. Outpatient Rehab Facility
Facility Name	AAC DALLAS OUTPATIENT CENTER, LLC DBA GREENHOUSE OUTPATIENT CENTER
Street	2301 AVENUE J
City	ARLINGTON
State	TX
ZIP	76006
Phone	817 649-3821
CertificateType	4
CertificateEffectiveDate	5/27/2023
CertificateExpirationDate	5/26/2025
FacilityType	Waiver

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