45D2181768 CLIA NUMBER - CHARIS BEHAVIORAL HEALTH

Laboratory Demographics

CLIA Number: 45D2181768

Facility Name: CHARIS BEHAVIORAL HEALTH

Facility Address:
250 W SOUTHLAKE BLVD SUITE 250
SOUTHLAKE, TX
ZIP 76092
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Facility Phone Number: 817 997-4525

Facility Type: Hospital

Certificate Type: Waiver

NPI Number: 1124664123

Taxonomy: 261QM0801X - Clinic/Center

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
CertificateType	4
CertificateEffectiveDate	4/10/2024
CertificateExpirationDate	4/9/2026
FacilityType	Waiver

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