05D2230749 CLIA NUMBER - LIFESCAPE RECOVERY CENTER

Laboratory Demographics

  • CLIA Code: 05D2230749
  • Facility Name: LIFESCAPE RECOVERY CENTER
  • Facility Address: 1212 N VERMONT AVE
    LOS ANGELES, CA
    ZIP 90029
  • Facility Phone: 562 760-4418
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: KALPESH BHAVSAR
  • NPI Number: 1972106656
  • Taxonomy: 261QM0850X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2230749
LAB Type Comp. Outpatient Rehab Facility
Facility Name LIFESCAPE RECOVERY CENTER
Street 1212 N VERMONT AVE
City LOS ANGELES
State CA
ZIP 90029
Phone 562 760-4418
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/27/2025
Certificate Expiration Date 7/26/2027
Facility Type Comp. Outpatient Rehab Facility
Lab Director KALPESH BHAVSAR

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