05D2153689 CLIA NUMBER - VALLEY RESTORATION CENTER LLC

Laboratory Demographics

  • CLIA Code: 05D2153689
  • Facility Name: VALLEY RESTORATION CENTER LLC
  • Facility Address: 22900 VENTURA BOULEVARD
    WOODLAND HILLS, CA
    ZIP 91364
  • Facility Phone: 818 519-0670
  • Facility Type: Other - OUTPATIENT SUBSATNCE ABUS
  • Facility Type: Waiver
  • Lab Director: RYAN C. PETERSON
  • NPI Number: 1417328618
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2153689
LAB Type Other - OUTPATIENT SUBSATNCE ABUS
Facility Name VALLEY RESTORATION CENTER LLC
Street 22900 VENTURA BOULEVARD
City WOODLAND HILLS
State CA
ZIP 91364
Phone 818 519-0670
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/28/2024
Certificate Expiration Date 8/27/2026
Facility Type Other - OUTPATIENT SUBSATNCE ABUS
Lab Director RYAN C. PETERSON

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