05D2212481 CLIA NUMBER - GLENDORA RECOVERY CENTER

Laboratory Demographics

  • CLIA Code: 05D2212481
  • Facility Name: GLENDORA RECOVERY CENTER
  • Facility Address: 1135 E ROUTE 66 STE 209
    GLENDORA, CA
    ZIP 91740
  • Facility Phone: 626 594-0881
  • Facility Type: Other - SUBSTANCE USE OUT PATIENT
  • Facility Type: Waiver
  • Lab Director: JEFFREY KRONSON
  • NPI Number: 1750849071
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2212481
LAB Type Other - SUBSTANCE USE OUT PATIENT
Facility Name GLENDORA RECOVERY CENTER
Street 1135 E ROUTE 66 STE 209
City GLENDORA
State CA
ZIP 91740
Phone 626 594-0881
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/4/2025
Certificate Expiration Date 2/3/2027
Facility Type Other - SUBSTANCE USE OUT PATIENT
Lab Director JEFFREY KRONSON

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