05D2202059 CLIA NUMBER - AEGIS TREATMENT CENTERS LLC

Laboratory Demographics

  • CLIA Code: 05D2202059
  • Facility Name: AEGIS TREATMENT CENTERS LLC
  • Facility Address: 955 W CENTER ST STRE 12B
    MANTECA, CA
    ZIP 95337
  • Facility Phone: 818 206-0360
  • Facility Type: Other - NTP
  • Facility Type: Waiver
  • Lab Director: MICHELLE J. ROWE
  • NPI Number: 1114083771
  • Taxonomy: 261QM2800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2202059
LAB Type Other - NTP
Facility Name AEGIS TREATMENT CENTERS LLC
Street 955 W CENTER ST STRE 12B
City MANTECA
State CA
ZIP 95337
Phone 818 206-0360
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/24/2024
Certificate Expiration Date 11/23/2026
Facility Type Other - NTP
Lab Director MICHELLE J. ROWE

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