05D2317567 CLIA NUMBER - INVIGORATE BEHAVIORAL HEALTH

Laboratory Demographics

  • CLIA Code: 05D2317567
  • Facility Name: INVIGORATE BEHAVIORAL HEALTH
  • Facility Address: 555 N MARIPOSA AVE
    LOS ANGELES, CA
    ZIP 90004
  • Facility Phone: 949 924-2114
  • Facility Type: Other - SUD RESIDENTIAL TREATMENT
  • Facility Type: Waiver
  • Lab Director: CHRISTIAN SMALL
  • NPI Number: 1417690983
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2317567
LAB Type Other - SUD RESIDENTIAL TREATMENT
Facility Name INVIGORATE BEHAVIORAL HEALTH
Street 555 N MARIPOSA AVE
City LOS ANGELES
State CA
ZIP 90004
Phone 949 924-2114
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/27/2025
Certificate Expiration Date 1/26/2027
Facility Type Other - SUD RESIDENTIAL TREATMENT
Lab Director CHRISTIAN SMALL

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