05D2285206 CLIA NUMBER - LIGHTFULLY BEHAVORIAL HEALTH - SOL

Laboratory Demographics

CLIA Code: 05D2285206
Facility Name: LIGHTFULLY BEHAVORIAL HEALTH - SOL
Facility Address: 1414 SAN VICENTE BLVD
SANTA MONICA, CA
ZIP 90402
Facility Phone: 818 483-0865
Facility Type: Skilled Nursing Facility/Nursing Facility
Facility Type: Waiver
Lab Director: KATHRYN HIRST
NPI Number: 1235673963
Taxonomy: 320800000X - Community Based Residential Treatment Facility, Mental Illness

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CLIA Record

Field Name	Field Value
CLIA Number	05D2285206
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	LIGHTFULLY BEHAVORIAL HEALTH - SOL
Street	1414 SAN VICENTE BLVD
City	SANTA MONICA
State	CA
ZIP	90402
Phone	818 483-0865
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	7/7/2025
Certificate Expiration Date	7/6/2027
Facility Type	Skilled Nursing Facility/Nursing Facility
Lab Director	KATHRYN HIRST

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