05D2256515 CLIA NUMBER - DESTINY RECOVERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 05D2256515
  • Facility Name: DESTINY RECOVERY CENTER LLC
  • Facility Address: 1539 CAROLYN CT
    REDLANDS, CA
    ZIP 92374
  • Facility Phone: 714 323-3605
  • Facility Type: Other - DETOX & RESIDENTIAL SUD T
  • Facility Type: Waiver
  • Lab Director: DAVID DEYHIMY
  • NPI Number: 1114393832
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2256515
LAB Type Other - DETOX & RESIDENTIAL SUD T
Facility Name DESTINY RECOVERY CENTER LLC
Street 1539 CAROLYN CT
City REDLANDS
State CA
ZIP 92374
Phone 714 323-3605
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2024
Certificate Expiration Date 3/23/2026
Facility Type Other - DETOX & RESIDENTIAL SUD T
Lab Director DAVID DEYHIMY

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