05D2303456 CLIA NUMBER - 90210 RECOVERY

Laboratory Demographics

  • CLIA Code: 05D2303456
  • Facility Name: 90210 RECOVERY
  • Facility Address: 1775 SUMMITRIDGE DR
    BEVERLY HILLS, CA
    ZIP 90210
  • Facility Phone: 408 813-2323
  • Facility Type: Other - RESIDENTIAL TREAT
  • Facility Type: Waiver
  • Lab Director: GEOFFREY BOOTH
  • NPI Number: 1538858113
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2303456
LAB Type Other - RESIDENTIAL TREAT
Facility Name 90210 RECOVERY
Street 1775 SUMMITRIDGE DR
City BEVERLY HILLS
State CA
ZIP 90210
Phone 408 813-2323
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/25/2024
Certificate Expiration Date 4/24/2026
Facility Type Other - RESIDENTIAL TREAT
Lab Director GEOFFREY BOOTH

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This page was last updated on: 6/4/2025