05D2116471 CLIA NUMBER - HOUSE OF HOPE

Laboratory Demographics

CLIA Number: 05D2116471

Facility Name: HOUSE OF HOPE

Facility Address:
235 W 9TH ST
SAN PEDRO, CA
ZIP 90733
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Facility Phone Number: 310 521-9209

Facility Type: Other - SUBSTANCE ABUSE TREATMENT

Certificate Type: Waiver

NPI Number: 1043829971

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2116471
LAB Type	Other - SUBSTANCE ABUSE TREATMENT
Facility Name	HOUSE OF HOPE
Street	235 W 9TH ST
City	SAN PEDRO
State	CA
ZIP	90733
Phone	310 521-9209
CertificateType	4
CertificateEffectiveDate	7/26/2022
CertificateExpirationDate	7/25/2024
FacilityType	Waiver

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