45D2210660 CLIA NUMBER - BROOKDALE LEWISVILLE

Laboratory Demographics

CLIA Number: 45D2210660

Facility Name: BROOKDALE LEWISVILLE

Facility Address:
965 N GARDEN RIDGE BLVD
LEWISVILLE, TX
ZIP 75077
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Facility Phone Number: 972 821-2324

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1285790444

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	45D2210660
LAB Type	Assisted Living Facility
Facility Name	BROOKDALE LEWISVILLE
Street	965 N GARDEN RIDGE BLVD
City	LEWISVILLE
State	TX
ZIP	75077
Phone	972 821-2324
CertificateType	4
CertificateEffectiveDate	1/22/2023
CertificateExpirationDate	1/21/2025
FacilityType	Waiver

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