05D2290962 CLIA NUMBER - SOLACE TREATMENT CENTER LLC

Laboratory Demographics

CLIA Number: 05D2290962

Facility Name: SOLACE TREATMENT CENTER LLC

Facility Address:
12824 HADLEY ST STE 107
WHITTIER, CA
ZIP 90601
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Facility Phone Number: 714 494-5171

Facility Type: Other - SUBSTANCE ABUSE FACILITY

Certificate Type: Waiver

NPI Number: 1518619733

Taxonomy: 261QM0801X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2290962
LAB Type	Other - SUBSTANCE ABUSE FACILITY
Facility Name	SOLACE TREATMENT CENTER LLC
Street	12824 HADLEY ST STE 107
City	WHITTIER
State	CA
ZIP	90601
Phone	714 494-5171
CertificateType	4
CertificateEffectiveDate	10/3/2023
CertificateExpirationDate	10/2/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024