05D2312123 CLIA NUMBER - LEGACY HEALING CENTER CALIFORNIA, LLC

Laboratory Demographics

  • CLIA Code: 05D2312123
  • Facility Name: LEGACY HEALING CENTER CALIFORNIA, LLC
  • Facility Address: 2462 SOLAR DRIVE
    LOS ANGELES, CA
    ZIP 90046
  • Facility Phone: 561 308-0865
  • Facility Type: Other - SUD TREATMENT
  • Facility Type: Waiver
  • Lab Director: ERIC CHAGHOURI
  • NPI Number: 1255037487
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2312123
LAB Type Other - SUD TREATMENT
Facility Name LEGACY HEALING CENTER CALIFORNIA, LLC
Street 2462 SOLAR DRIVE
City LOS ANGELES
State CA
ZIP 90046
Phone 561 308-0865
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/4/2024
Certificate Expiration Date 10/3/2026
Facility Type Other - SUD TREATMENT
Lab Director ERIC CHAGHOURI

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