05D2110453 CLIA NUMBER - BEHAVIORAL HEALTH SERVICES

Laboratory Demographics

  • CLIA Code: 05D2110453
  • Facility Name: BEHAVIORAL HEALTH SERVICES
  • Facility Address: 2501 W EL SEGUNDO BLVD, STE B
    HAWTHORNE, CA
    ZIP 90250
  • Facility Phone: 310 679-9126
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: EVELYN T. CHANG
  • NPI Number: 1013528108
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2110453
LAB Type Federally Qualified Health Center
Facility Name BEHAVIORAL HEALTH SERVICES
Street 2501 W EL SEGUNDO BLVD, STE B
City HAWTHORNE
State CA
ZIP 90250
Phone 310 679-9126
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2024
Certificate Expiration Date 3/14/2026
Facility Type Federally Qualified Health Center
Lab Director EVELYN T. CHANG

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