05D2070101 CLIA NUMBER - FAITH RECOVERY

Laboratory Demographics

  • CLIA Code: 05D2070101
  • Facility Name: FAITH RECOVERY
  • Facility Address: 1837 SHIPWAY AVE
    LONG BEACH, CA
    ZIP 90815
  • Facility Phone: 562 881-2322
  • Facility Type: Other - OUTPATIENT SUBSTANCE ABUS
  • Facility Type: Waiver
  • Lab Director: ANDREI DOKUKIN
  • NPI Number: 1821410002
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2070101
LAB Type Other - OUTPATIENT SUBSTANCE ABUS
Facility Name FAITH RECOVERY
Street 1837 SHIPWAY AVE
City LONG BEACH
State CA
ZIP 90815
Phone 562 881-2322
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/10/2023
Certificate Expiration Date 12/9/2025
Facility Type Other - OUTPATIENT SUBSTANCE ABUS
Lab Director ANDREI DOKUKIN

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This page was last updated on: 9/29/2025