05D2298408 CLIA NUMBER - LOTUS RECOVERY SERVICES INC

Laboratory Demographics

  • CLIA Code: 05D2298408
  • Facility Name: LOTUS RECOVERY SERVICES INC
  • Facility Address: 191 W WILBUR RD SUITE 102
    THOUSAND OAKS, CA
    ZIP 91360
  • Facility Phone: 818 631-6492
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: SAMEER HASSAMAL
  • NPI Number: 1679270904
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2298408
LAB Type Comp. Outpatient Rehab Facility
Facility Name LOTUS RECOVERY SERVICES INC
Street 191 W WILBUR RD SUITE 102
City THOUSAND OAKS
State CA
ZIP 91360
Phone 818 631-6492
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/1/2024
Certificate Expiration Date 1/31/2026
Facility Type Comp. Outpatient Rehab Facility
Lab Director SAMEER HASSAMAL

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This page was last updated on: 6/4/2025