05D2034863 CLIA NUMBER - CASA DE LAS AMIGAS

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Laboratory Demographics

CLIA Number: 05D2034863

Facility Name: CASA DE LAS AMIGAS

Facility Address:
160 N EL MOLINO AVE
PASADENA, CA
ZIP 91101
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Facility Phone Number: 626 792-7220

Facility Type: Other - BEHAVIORAL HEALTH

Certificate Type: Waiver

NPI Number: 1851917033

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	05D2034863
LAB Type	Other - BEHAVIORAL HEALTH
Facility Name	CASA DE LAS AMIGAS
Street	160 N EL MOLINO AVE
City	PASADENA
State	CA
ZIP	91101
Phone	626 792-7220
CertificateType	4
CertificateEffectiveDate	6/10/2022
CertificateExpirationDate	6/9/2024
FacilityType	Waiver

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