05D2293049 CLIA NUMBER - PATHWAYS RECOVERY CENTER

Laboratory Demographics

CLIA Number: 05D2293049

Facility Name: PATHWAYS RECOVERY CENTER

Facility Address:
1033 N SOLDANO AVE
AZUSA, CA
ZIP 91702
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Facility Phone Number: 888 711-0966

Facility Type: Other - RESIDENTIAL TREAT FACIL

Certificate Type: Waiver

NPI Number: 1720659816

Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

CLIA Record

Field Name	Field Value
CLIA Number	05D2293049
LAB Type	Other - RESIDENTIAL TREAT FACIL
Facility Name	PATHWAYS RECOVERY CENTER
Street	1033 N SOLDANO AVE
City	AZUSA
State	CA
ZIP	91702
Phone	888 711-0966
CertificateType	4
CertificateEffectiveDate	11/2/2023
CertificateExpirationDate	11/1/2025
FacilityType	Waiver

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