05D0705965 CLIA NUMBER - WCHS, INC DBA COLTON CLINICAL SERVICES

Laboratory Demographics

CLIA Number: 05D0705965

Facility Name: WCHS, INC DBA COLTON CLINICAL SERVICES

Facility Address:
2275 E COOLEY DR
COLTON, CA
ZIP 92324
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Facility Phone Number: 909 370-1777

Facility Type: Comp. Outpatient Rehab Facility

Certificate Type: Waiver

NPI Number: 1568522928

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	05D0705965
LAB Type	Comp. Outpatient Rehab Facility
Facility Name	WCHS, INC DBA COLTON CLINICAL SERVICES
Street	2275 E COOLEY DR
City	COLTON
State	CA
ZIP	92324
Phone	909 370-1777
CertificateType	4
CertificateEffectiveDate	1/18/2024
CertificateExpirationDate	1/17/2026
FacilityType	Waiver

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