05D2301654 CLIA NUMBER - WESTLARECOVERY, INC.

Laboratory Demographics

  • CLIA Code: 05D2301654
  • Facility Name: WESTLARECOVERY, INC.
  • Facility Address: 1728 ABBOT KINNEY BOULEVARD, STE 101
    VENICE, CA
    ZIP 90291
  • Facility Phone: 310 592-0139
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: ERIC CHAGHOURI
  • NPI Number: 1245096726
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2301654
LAB Type Comp. Outpatient Rehab Facility
Facility Name WESTLARECOVERY, INC.
Street 1728 ABBOT KINNEY BOULEVARD, STE 101
City VENICE
State CA
ZIP 90291
Phone 310 592-0139
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/28/2024
Certificate Expiration Date 3/27/2026
Facility Type Comp. Outpatient Rehab Facility
Lab Director ERIC CHAGHOURI

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