45D2181768 CLIA NUMBER - CHARIS BEHAVIORAL HEALTH

Laboratory Demographics

  • CLIA Code: 45D2181768
  • Facility Name: CHARIS BEHAVIORAL HEALTH
  • Facility Address: 250 W SOUTHLAKE BLVD SUITE 250
    SOUTHLAKE, TX
    ZIP 76092
  • Facility Phone: 817 997-4525
  • Facility Type: Hospital
  • Facility Type: Waiver
  • Lab Director: TAE Y. LEE
  • NPI Number: 1124664123
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2181768
LAB Type Hospital
Facility Name CHARIS BEHAVIORAL HEALTH
Street 250 W SOUTHLAKE BLVD SUITE 250
City SOUTHLAKE
State TX
ZIP 76092
Phone 817 997-4525
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/10/2024
Certificate Expiration Date 4/9/2026
Facility Type Hospital
Lab Director TAE Y. LEE

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This page was last updated on: 6/4/2025