05D2268243 CLIA NUMBER - AEGIS TREATMENT CENTERS, LLC

Laboratory Demographics

  • CLIA Code: 05D2268243
  • Facility Name: AEGIS TREATMENT CENTERS, LLC
  • Facility Address: 691 PAULINE CT
    SONORA, CA
    ZIP 95370
  • Facility Phone: 818 206-0360
  • Facility Type: Other - NARCATIC TREATMENT PROGRA
  • Facility Type: Waiver
  • Lab Director: ROBERT C. SOUTHMAYD
  • NPI Number: 1659436095
  • Taxonomy: 261QM2800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2268243
LAB Type Other - NARCATIC TREATMENT PROGRA
Facility Name AEGIS TREATMENT CENTERS, LLC
Street 691 PAULINE CT
City SONORA
State CA
ZIP 95370
Phone 818 206-0360
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/8/2024
Certificate Expiration Date 9/7/2026
Facility Type Other - NARCATIC TREATMENT PROGRA
Lab Director ROBERT C. SOUTHMAYD

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