05D2185987 CLIA NUMBER - HOUSE OF HOPE

Laboratory Demographics

CLIA Number: 05D2185987

Facility Name: HOUSE OF HOPE

Facility Address:
205 W 9TH STREET
SAN PEDRO, CA
ZIP 90731
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Facility Phone Number: 310 521-9209

Facility Type: Other - SUBSTANCE ABUSE TREATMENT

Certificate Type: Waiver

NPI Number: 1740627843

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	05D2185987
LAB Type	Other - SUBSTANCE ABUSE TREATMENT
Facility Name	HOUSE OF HOPE
Street	205 W 9TH STREET
City	SAN PEDRO
State	CA
ZIP	90731
Phone	310 521-9209
CertificateType	4
CertificateEffectiveDate	6/11/2022
CertificateExpirationDate	6/10/2024
FacilityType	Waiver

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