05D2314805 CLIA NUMBER - GODS ARMY WELLNESS HOME INC

Laboratory Demographics

  • CLIA Code: 05D2314805
  • Facility Name: GODS ARMY WELLNESS HOME INC
  • Facility Address: 13149 RATNER ST
    N HOLLYWOOD, CA
    ZIP 91605
  • Facility Phone: 818 205-1111
  • Facility Type: Other - SUBS. ABUSE REHAB FCLTY
  • Facility Type: Waiver
  • Lab Director: RAAFAT W. GIRGIS
  • NPI Number: 1669009239
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2314805
LAB Type Other - SUBS. ABUSE REHAB FCLTY
Facility Name GODS ARMY WELLNESS HOME INC
Street 13149 RATNER ST
City N HOLLYWOOD
State CA
ZIP 91605
Phone 818 205-1111
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/27/2024
Certificate Expiration Date 11/26/2026
Facility Type Other - SUBS. ABUSE REHAB FCLTY
Lab Director RAAFAT W. GIRGIS

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