05D2285637 CLIA NUMBER - INNOVATE RECOVERY LLC

Laboratory Demographics

  • CLIA Code: 05D2285637
  • Facility Name: INNOVATE RECOVERY LLC
  • Facility Address: 14718 KESWICK ST
    VAN NUYS, CA
    ZIP 91405
  • Facility Phone: 800 955-1517
  • Facility Type: Other - SUBSTANCE USE DISORDER TR
  • Facility Type: Waiver
  • Lab Director: CHRISTIAN SMALL
  • NPI Number: 1619667953
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2285637
LAB Type Other - SUBSTANCE USE DISORDER TR
Facility Name INNOVATE RECOVERY LLC
Street 14718 KESWICK ST
City VAN NUYS
State CA
ZIP 91405
Phone 800 955-1517
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/14/2023
Certificate Expiration Date 7/13/2025
Facility Type Other - SUBSTANCE USE DISORDER TR
Lab Director CHRISTIAN SMALL

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This page was last updated on: 6/4/2025