45D2275382 CLIA NUMBER - DALLAS DETOX CENTER

Laboratory Demographics

  • CLIA Code: 45D2275382
  • Facility Name: DALLAS DETOX CENTER
  • Facility Address: 100 MARIAH DR
    WEATHERFORD, TX
    ZIP 76087
  • Facility Phone: 817 598-0040
  • Facility Type: Other - DETOX & RESIDENTIAL SUD
  • Facility Type: Waiver
  • Lab Director: CHRISTIAN SMALL
  • NPI Number: 1689392987
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 45D2275382
LAB Type Other - DETOX & RESIDENTIAL SUD
Facility Name DALLAS DETOX CENTER
Street 100 MARIAH DR
City WEATHERFORD
State TX
ZIP 76087
Phone 817 598-0040
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/20/2025
Certificate Expiration Date 1/19/2027
Facility Type Other - DETOX & RESIDENTIAL SUD
Lab Director CHRISTIAN SMALL

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