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AVEDIS DETOX INC.
NPI 1124666334
Substance Abuse Rehabilitation Facility in Los Angeles, CA

Active since December 18, 2019CLIA 05D2191303 · Waiver
1122 S CITRUS AVE, LOS ANGELES, CA 90019(323) 243-3422 Get Directions Write a Review

NPPES record last updated: November 5, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 5, 2024, May 12, 2022, Dec 18, 2019 (3 updates tracked since 2019).

About Avedis Detox Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AVEDIS DETOX INC. (NPI 1124666334) is a healthcare organization registered as a substance abuse rehabilitation facility in Los Angeles, California and active in the NPI registry since December 2019. The organization holds a CLIA Waiver certificate valid through November 19, 2026 and lists George Sarkis Degirmendjian, Ceo, as its authorized official.

NPPES Registry Identity

NPI1124666334
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameAVEDIS DETOX INC.
Location Address1122 S CITRUS AVELos Angeles, CA 90019-1642
Mailing Address1122 S Citrus AveLos Angeles, CA 90019-1642 · (323) 243-3422
Phone(323) 243-3422
Organization SubpartNo
Authorized OfficialGeorge Sarkis DegirmendjianCeo · (323) 243-3422
Enumeration DateDecember 18, 2019
Last NPPES UpdateNovember 5, 20243 updates tracked since enumeration
NPPES CertifiedNovember 5, 2024
✔ NPI 1124666334 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
1122 S CITRUS AVE, Los Angeles, CA 90019
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2191303

Avedis Detox Inc · Los Angeles, CA
Active · expires Nov 19, 2026
CLIA Number05D2191303
Laboratory TypeAncillary Testing Site In Health Care Center
Certificate Effective DateNovember 20, 2024
Certificate Expiration DateNovember 19, 2026
Laboratory DirectorJohnathan Reitman
Laboratory Phone(323) 243-3422
Laboratory LocationAvedis Detox Inc1122V S Citrus Ave, Los Angeles, CA 90019
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Avedis Detox Inc.'s NPI number?

The NPI number for Avedis Detox Inc. is 1124666334. It was assigned to this organization in the NPPES registry on December 18, 2019.

Where is Avedis Detox Inc. located?

Avedis Detox Inc. is located at 1122 S Citrus Ave, Los Angeles, CA 90019. The listed phone number is (323) 243-3422.

What is Avedis Detox Inc.'s specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Does Avedis Detox Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2191303) is associated with this NPI, valid through November 19, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Avedis Detox Inc. was last updated on November 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.