05D2292668 CLIA NUMBER - CLEAR RECOVERY CENTER - SAN VICENTE BLVD

Laboratory Demographics

  • CLIA Code: 05D2292668
  • Facility Name: CLEAR RECOVERY CENTER - SAN VICENTE BLVD
  • Facility Address: 640 S SAN VICENTE BLVD
    LOS ANGELES, CA
    ZIP 90048
  • Facility Phone: 424 477-9547
  • Facility Type: Other - BEHAVIORAL HEALTH OUTPATI
  • Facility Type: Waiver
  • Lab Director: HAIYAN WANG
  • NPI Number: 1972175065
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 05D2292668
LAB Type Other - BEHAVIORAL HEALTH OUTPATI
Facility Name CLEAR RECOVERY CENTER - SAN VICENTE BLVD
Street 640 S SAN VICENTE BLVD
City LOS ANGELES
State CA
ZIP 90048
Phone 424 477-9547
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/27/2023
Certificate Expiration Date 10/26/2025
Facility Type Other - BEHAVIORAL HEALTH OUTPATI
Lab Director HAIYAN WANG

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