05D0686990 CLIA NUMBER - AEGIS TREATMENT CENTERS, LLC

Laboratory Demographics

CLIA Number: 05D0686990

Facility Name: AEGIS TREATMENT CENTERS, LLC

Facility Address:
125 W F ST
ONTARIO, CA
ZIP 91762
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Facility Phone Number: 818 206-0360

Facility Type: Other - NARCOTIC TREATMENT PROGRA

Certificate Type: Waiver

NPI Number: 1013353861

Taxonomy: 261QM2800X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.

CLIA Record

Field Name	Field Value
CLIA Number	05D0686990
LAB Type	Other - NARCOTIC TREATMENT PROGRA
Facility Name	AEGIS TREATMENT CENTERS, LLC
Street	125 W F ST
City	ONTARIO
State	CA
ZIP	91762
Phone	818 206-0360
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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