05D2129044 CLIA NUMBER - RECOVERY MALIBU, INC

Laboratory Demographics

CLIA Number: 05D2129044

Facility Name: RECOVERY MALIBU, INC

Facility Address:
20723 ROCKCROFT DR
MALIBU, CA
ZIP 90265
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Facility Phone Number: 424 781-4705

Facility Type: Other - FACILITY

Certificate Type: Waiver

NPI Number: 1093182198

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	05D2129044
LAB Type	Other - FACILITY
Facility Name	RECOVERY MALIBU, INC
Street	20723 ROCKCROFT DR
City	MALIBU
State	CA
ZIP	90265
Phone	424 781-4705
CertificateType	4
CertificateEffectiveDate	4/11/2023
CertificateExpirationDate	4/10/2025
FacilityType	Waiver

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