05D2304911 CLIA NUMBER - SIMPLE PATH RECOVERY LLC

Laboratory Demographics

  • CLIA Code: 05D2304911
  • Facility Name: SIMPLE PATH RECOVERY LLC
  • Facility Address: 968 LINCOLN AVE
    POMONA, CA
    ZIP 91767
  • Facility Phone: 562 528-1966
  • Facility Type: Other - OUTPATIENT SUBSTANCE ABUS
  • Facility Type: Waiver
  • Lab Director: LAWRENCE TUCKER
  • NPI Number: 1164282463
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2304911
LAB Type Other - OUTPATIENT SUBSTANCE ABUS
Facility Name SIMPLE PATH RECOVERY LLC
Street 968 LINCOLN AVE
City POMONA
State CA
ZIP 91767
Phone 562 528-1966
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2024
Certificate Expiration Date 5/20/2026
Facility Type Other - OUTPATIENT SUBSTANCE ABUS
Lab Director LAWRENCE TUCKER

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