05D2265318 CLIA NUMBER - EAGLE RECOVERY

Laboratory Demographics

  • CLIA Code: 05D2265318
  • Facility Name: EAGLE RECOVERY
  • Facility Address: 6701 CANTALOUPE AVE
    VAN NUYS, CA
    ZIP 91405
  • Facility Phone: 818 276-5436
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: DAGMAR I. LIEPA
  • NPI Number: 1306420385
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2265318
LAB Type Ancillary Testing Site in Health Care Center
Facility Name EAGLE RECOVERY
Street 6701 CANTALOUPE AVE
City VAN NUYS
State CA
ZIP 91405
Phone 818 276-5436
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/26/2024
Certificate Expiration Date 7/25/2026
Facility Type Ancillary Testing Site in Health Care Center
Lab Director DAGMAR I. LIEPA

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