05D2220206 CLIA NUMBER - DESERT BLOOM RECOVERY LLC

Laboratory Demographics

  • CLIA Code: 05D2220206
  • Facility Name: DESERT BLOOM RECOVERY LLC
  • Facility Address: 14286 CALIFORNIA AVE SUITE 102
    VICTORVILLE, CA
    ZIP 92392
  • Facility Phone: 888 503-1503
  • Facility Type: Other - SUBSTANCE ABUSE OUTPT FAC
  • Facility Type: Waiver
  • Lab Director: MICHAEL S. VALDEZ
  • NPI Number: 1811534811
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2220206
LAB Type Other - SUBSTANCE ABUSE OUTPT FAC
Facility Name DESERT BLOOM RECOVERY LLC
Street 14286 CALIFORNIA AVE SUITE 102
City VICTORVILLE
State CA
ZIP 92392
Phone 888 503-1503
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/9/2025
Certificate Expiration Date 4/8/2027
Facility Type Other - SUBSTANCE ABUSE OUTPT FAC
Lab Director MICHAEL S. VALDEZ

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