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45D2236780 CLIA NUMBER - PRIME WELLNESS CENTER, PLLC DBA REFLECTIONS LIFESTYLE CENTER

Laboratory Demographics

CLIA Number: 45D2236780

Facility Name: PRIME WELLNESS CENTER, PLLC DBA REFLECTIONS LIFESTYLE CENTER

Facility Address:
4901 WINDHAVEN PARKWAY SUITE 200
THE COLONY, TX
ZIP 75056
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Facility Phone Number: 469 777-4688

Facility Type: Other - PHP/IOP

Certificate Type: Waiver
NPI Number: 1548865678

Taxonomy: 3245S0500X - Substance Abuse Rehabilitation Facility
A facility or distinct part of a facility for children that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included.

CLIA Record

Field Name Field Value
CLIA Number 45D2236780
LAB Type Other - PHP/IOP
Facility Name PRIME WELLNESS CENTER, PLLC DBA REFLECTIONS LIFESTYLE CENTER
Street 4901 WINDHAVEN PARKWAY SUITE 200
City THE COLONY
State TX
ZIP 75056
Phone 469 777-4688
CertificateType 4
CertificateEffectiveDate 9/20/2023
CertificateExpirationDate 9/19/2025
FacilityType Waiver

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