05D2304931 CLIA NUMBER - MALIBU RECOVERY CENTER

Laboratory Demographics

  • CLIA Code: 05D2304931
  • Facility Name: MALIBU RECOVERY CENTER
  • Facility Address: 12532 VENTURA BLVD
    STUDIO CITY, CA
    ZIP 91604
  • Facility Phone: 805 512-1694
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: LISA TOMSAK
  • NPI Number: 1770270415
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2304931
LAB Type Comp. Outpatient Rehab Facility
Facility Name MALIBU RECOVERY CENTER
Street 12532 VENTURA BLVD
City STUDIO CITY
State CA
ZIP 91604
Phone 805 512-1694
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 Comp. Outpatient Rehab Facility
Lab Director LISA TOMSAK

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