05D2125649 CLIA NUMBER - FRED BROWN RECOVERY SERVICES INC

Laboratory Demographics

  • CLIA Code: 05D2125649
  • Facility Name: FRED BROWN RECOVERY SERVICES INC
  • Facility Address: 270 W 14TH ST
    SAN PEDRO, CA
    ZIP 90731
  • Facility Phone: 310 519-8723
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: RICHARD S. MERRICK
  • NPI Number: 1033733811
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2125649
LAB Type Comp. Outpatient Rehab Facility
Facility Name FRED BROWN RECOVERY SERVICES INC
Street 270 W 14TH ST
City SAN PEDRO
State CA
ZIP 90731
Phone 310 519-8723
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/10/2025
Certificate Expiration Date 2/9/2027
Facility Type Comp. Outpatient Rehab Facility
Lab Director RICHARD S. MERRICK

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