45D2125547 CLIA NUMBER - CYPRESS LAKES LODGE, LLC DBA CYPRESS LAKES RECOVERY

Laboratory Demographics

  • CLIA Code: 45D2125547
  • Facility Name: CYPRESS LAKES LODGE, LLC DBA CYPRESS LAKES RECOVERY
  • Facility Address: 1129 US HWY 287 NORTH
    WOODVILLE, TX
    ZIP 75979
  • Facility Phone: 956 299-4699
  • Facility Type: Other - SUBSTANCE ABUSE CTR
  • Facility Type: Waiver
  • Lab Director: TANISHA HOLLIS
  • NPI Number: 1831642933
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 45D2125547
LAB Type Other - SUBSTANCE ABUSE CTR
Facility Name CYPRESS LAKES LODGE, LLC DBA CYPRESS LAKES RECOVERY
Street 1129 US HWY 287 NORTH
City WOODVILLE
State TX
ZIP 75979
Phone 956 299-4699
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/9/2025
Certificate Expiration Date 2/8/2027
Facility Type Other - SUBSTANCE ABUSE CTR
Lab Director TANISHA HOLLIS

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This page was last updated on: 9/29/2025