50D2049389 CLIA NUMBER - FREE BY THE SEA DRUG AND ALCOHOL REHABILITATION

Home > CLIA Lookup > 50D2049389

Laboratory Demographics

CLIA Number: 50D2049389

Facility Name: FREE BY THE SEA DRUG AND ALCOHOL REHABILITATION

Facility Address:
25517 PARK AVE
OCEAN PARK, WA
ZIP 98640
Get Directions

Facility Phone Number: 360 665-4494

Facility Type: Other - DRUG TREATMENT

Certificate Type: Waiver

NPI Number: 1225300213

Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

CLIA Record

Field Name	Field Value
CLIA Number	50D2049389
LAB Type	Other - DRUG TREATMENT
Facility Name	FREE BY THE SEA DRUG AND ALCOHOL REHABILITATION
Street	25517 PARK AVE
City	OCEAN PARK
State	WA
ZIP	98640
Phone	360 665-4494
CertificateType	4
CertificateEffectiveDate	9/12/2019
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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