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05D0706026 CLIA NUMBER - TRANSCULTURAL HEALTH DEVELOPMENT, INC D/B/A COASTAL RECOVERY CENTER

Laboratory Demographics

CLIA Number: 05D0706026

Facility Name: TRANSCULTURAL HEALTH DEVELOPMENT, INC D/B/A COASTAL RECOVERY CENTER

Facility Address:
117 E HARRY BRIDGES BLVD
WILMINGTON, CA
ZIP 90744
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Facility Phone Number: 310 549-8383

Facility Type: Comp. Outpatient Rehab Facility

Certificate Type: Waiver
NPI Number: 1053322909

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 05D0706026
LAB Type Comp. Outpatient Rehab Facility
Facility Name TRANSCULTURAL HEALTH DEVELOPMENT, INC D/B/A COASTAL RECOVERY CENTER
Street 117 E HARRY BRIDGES BLVD
City WILMINGTON
State CA
ZIP 90744
Phone 310 549-8383
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