05D2138928 CLIA NUMBER - AEGIS TREATMENT CENTERS, LLC

Laboratory Demographics

  • CLIA Code: 05D2138928
  • Facility Name: AEGIS TREATMENT CENTERS, LLC
  • Facility Address: 109 MARGARET LANE
    GRASS VALLEY, CA
    ZIP 95945
  • Facility Phone: 800 821-0775
  • Facility Type: Other - NARCOTIC TRTMT PROGRAM
  • Facility Type: Waiver
  • Lab Director: MICHAEL J. WARING
  • NPI Number: 1548819550
  • Taxonomy: 261QM2800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2138928
LAB Type Other - NARCOTIC TRTMT PROGRAM
Facility Name AEGIS TREATMENT CENTERS, LLC
Street 109 MARGARET LANE
City GRASS VALLEY
State CA
ZIP 95945
Phone 800 821-0775
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/26/2023
Certificate Expiration Date 10/25/2025
Facility Type Other - NARCOTIC TRTMT PROGRAM
Lab Director MICHAEL J. WARING

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