05D2214591 CLIA NUMBER - THE LIVINGOOD CENTER LLC

Laboratory Demographics

CLIA Number: 05D2214591

Facility Name: THE LIVINGOOD CENTER LLC

Facility Address:
2134 MAIN STREET
HUNTINGTON BEACH, CA
ZIP 92648
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Facility Phone Number: 949 355-3962

Facility Type: Comp. Outpatient Rehab Facility

Certificate Type: Waiver

NPI Number: 1326506460

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2214591
LAB Type	Comp. Outpatient Rehab Facility
Facility Name	THE LIVINGOOD CENTER LLC
Street	2134 MAIN STREET
City	HUNTINGTON BEACH
State	CA
ZIP	92648
Phone	949 355-3962
CertificateType	4
CertificateEffectiveDate	2/23/2023
CertificateExpirationDate	2/22/2025
FacilityType	Waiver

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