05D2227988 CLIA NUMBER - GRANDVIEW FOUNDATION INC

Laboratory Demographics

CLIA Number: 05D2227988

Facility Name: GRANDVIEW FOUNDATION INC

Facility Address:
1230 N MARENGO AVE
PASADENA, CA
ZIP 91103
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Facility Phone Number: 626 797-1124

Facility Type: Other - SUBSTANCE USE DISORDER TR

Certificate Type: Waiver

NPI Number: 1669923611

Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

CLIA Record

Field Name	Field Value
CLIA Number	05D2227988
LAB Type	Other - SUBSTANCE USE DISORDER TR
Facility Name	GRANDVIEW FOUNDATION INC
Street	1230 N MARENGO AVE
City	PASADENA
State	CA
ZIP	91103
Phone	626 797-1124
CertificateType	4
CertificateEffectiveDate	6/21/2023
CertificateExpirationDate	6/20/2025
FacilityType	Waiver

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