05D2307524 CLIA NUMBER - SKYLINE RECOVERY CENTER

Laboratory Demographics

  • CLIA Code: 05D2307524
  • Facility Name: SKYLINE RECOVERY CENTER
  • Facility Address: 1517 SEPULVEDA BLVD
    LOS ANGELES, CA
    ZIP 90025
  • Facility Phone: 323 599-3163
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: RYAN PETERSON
  • NPI Number: 1760180699
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2307524
LAB Type Independent
Facility Name SKYLINE RECOVERY CENTER
Street 1517 SEPULVEDA BLVD
City LOS ANGELES
State CA
ZIP 90025
Phone 323 599-3163
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/10/2024
Certificate Expiration Date 7/9/2026
Facility Type Independent
Lab Director RYAN PETERSON

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