05D2313061 CLIA NUMBER - LA WELLNESS HAVEN

Laboratory Demographics

  • CLIA Code: 05D2313061
  • Facility Name: LA WELLNESS HAVEN
  • Facility Address: 8908 CANBY AVE
    NORTHRIDGE, CA
    ZIP 91325
  • Facility Phone: 818 644-0826
  • Facility Type: Other - RESIDENTIAL DRUG & ALCOHO
  • Facility Type: Waiver
  • Lab Director: ERIC CHAGHOURI
  • NPI Number: 1770358293
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2313061
LAB Type Other - RESIDENTIAL DRUG & ALCOHO
Facility Name LA WELLNESS HAVEN
Street 8908 CANBY AVE
City NORTHRIDGE
State CA
ZIP 91325
Phone 818 644-0826
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/23/2024
Certificate Expiration Date 10/22/2026
Facility Type Other - RESIDENTIAL DRUG & ALCOHO
Lab Director ERIC CHAGHOURI

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