05D2213091 CLIA NUMBER - GIBSON HOUSE FOR MEN

Laboratory Demographics

  • CLIA Code: 05D2213091
  • Facility Name: GIBSON HOUSE FOR MEN
  • Facility Address: 1100 NORTH D STREET
    SAN BERNARDINO, CA
    ZIP 92410
  • Facility Phone: 909 884-0840
  • Facility Type: Other - SUBSTANCE ABUSE CTR
  • Facility Type: Waiver
  • Lab Director: JULIE K. KASARJIAN
  • NPI Number: 1033311881
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2213091
LAB Type Other - SUBSTANCE ABUSE CTR
Facility Name GIBSON HOUSE FOR MEN
Street 1100 NORTH D STREET
City SAN BERNARDINO
State CA
ZIP 92410
Phone 909 884-0840
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/11/2024
Certificate Expiration Date 3/10/2026
Facility Type Other - SUBSTANCE ABUSE CTR
Lab Director JULIE K. KASARJIAN

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