05D2153938 CLIA NUMBER - HATHAWAY RECOVERY

Laboratory Demographics

CLIA Number: 05D2153938

Facility Name: HATHAWAY RECOVERY

Facility Address:
1042 E BELMONT ABBEY LANE
CLAREMONT, CA
ZIP 91711
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Facility Phone Number: 909 971-3333

Facility Type: Other - INPATIENT REHAB FACILITY

Certificate Type: Waiver

NPI Number: 1548718190

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	05D2153938
LAB Type	Other - INPATIENT REHAB FACILITY
Facility Name	HATHAWAY RECOVERY
Street	1042 E BELMONT ABBEY LANE
City	CLAREMONT
State	CA
ZIP	91711
Phone	909 971-3333
CertificateType	4
CertificateEffectiveDate	9/4/2022
CertificateExpirationDate	9/3/2024
FacilityType	Waiver

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