05D2239169 CLIA NUMBER - PATHWAYS RECOVERY

Laboratory Demographics

CLIA Number: 05D2239169

Facility Name: PATHWAYS RECOVERY

Facility Address:
775 SUNRISE AVE #210
ROSEVILLE, CA
ZIP 95661
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Facility Phone Number: 916 735-8977

Facility Type: Comp. Outpatient Rehab Facility

Certificate Type: Waiver

NPI Number: 1922512508

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	05D2239169
LAB Type	Comp. Outpatient Rehab Facility
Facility Name	PATHWAYS RECOVERY
Street	775 SUNRISE AVE #210
City	ROSEVILLE
State	CA
ZIP	95661
Phone	916 735-8977
CertificateType	4
CertificateEffectiveDate	10/8/2023
CertificateExpirationDate	10/7/2025
FacilityType	Waiver

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