05D2295671 CLIA NUMBER - VANITY DETOX CENTER INC

Laboratory Demographics

  • CLIA Code: 05D2295671
  • Facility Name: VANITY DETOX CENTER INC
  • Facility Address: 6416 BALCOM AVE
    RESEDA, CA
    ZIP 91335
  • Facility Phone: 323 620-0321
  • Facility Type: Other - RESIDENTIAL DRUG AND ALCO
  • Facility Type: Waiver
  • Lab Director: MARTIN SAHAKYAN
  • NPI Number: 1366131369
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2295671
LAB Type Other - RESIDENTIAL DRUG AND ALCO
Facility Name VANITY DETOX CENTER INC
Street 6416 BALCOM AVE
City RESEDA
State CA
ZIP 91335
Phone 323 620-0321
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/14/2023
Certificate Expiration Date 12/13/2025
Facility Type Other - RESIDENTIAL DRUG AND ALCO
Lab Director MARTIN SAHAKYAN

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