05D2285395 CLIA NUMBER - LIGHTFULLY BEHAVORIAL HEALTH - RAY

Laboratory Demographics

  • CLIA Code: 05D2285395
  • Facility Name: LIGHTFULLY BEHAVORIAL HEALTH - RAY
  • Facility Address: 10780 SANTA MONICA BLVD #440
    LOS ANGELES, CA
    ZIP 90025
  • Facility Phone: 818 483-0865
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: KATHRYN HIRST
  • NPI Number: 1124496039
  • Taxonomy: 261QM0850X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2285395
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name LIGHTFULLY BEHAVORIAL HEALTH - RAY
Street 10780 SANTA MONICA BLVD #440
City LOS ANGELES
State CA
ZIP 90025
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 7/11/2025
Certificate Expiration Date 7/10/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director KATHRYN HIRST

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