05D2153961 CLIA NUMBER - ROOTS INC DBA ROOTS THROUGH RECOVERY

Laboratory Demographics

  • CLIA Code: 05D2153961
  • Facility Name: ROOTS INC DBA ROOTS THROUGH RECOVERY
  • Facility Address: 3939 ATLANTIC AVE SUITE 102
    LONG BEACH, CA
    ZIP 90807
  • Facility Phone: 562 473-0827
  • Facility Type: Other - BEHAVIORAL HEALTH CLINIC
  • Facility Type: Waiver
  • Lab Director: ANDREI DOKUKIN
  • NPI Number: 1972939494
  • Taxonomy: 261QM0801X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2153961
LAB Type Other - BEHAVIORAL HEALTH CLINIC
Facility Name ROOTS INC DBA ROOTS THROUGH RECOVERY
Street 3939 ATLANTIC AVE SUITE 102
City LONG BEACH
State CA
ZIP 90807
Phone 562 473-0827
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/9/2024
Certificate Expiration Date 6/8/2026
Facility Type Other - BEHAVIORAL HEALTH CLINIC
Lab Director ANDREI DOKUKIN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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