05D2045838 CLIA NUMBER - 449 RECOVERY

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Laboratory Demographics

CLIA Number: 05D2045838

Facility Name: 449 RECOVERY

Facility Address:
26010 ACERO
MISSION VIEJO, CA
ZIP 92691
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Facility Phone Number: 855 449-4490

Facility Type: Other - INTENSIVE OUTPATIENT TREA

Certificate Type: Waiver

NPI Number: 1932473329

Taxonomy: 261QM0850X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

CLIA Record

Field Name	Field Value
CLIA Number	05D2045838
LAB Type	Other - INTENSIVE OUTPATIENT TREA
Facility Name	449 RECOVERY
Street	26010 ACERO
City	MISSION VIEJO
State	CA
ZIP	92691
Phone	855 449-4490
CertificateType	4
CertificateEffectiveDate	8/21/2022
CertificateExpirationDate	8/20/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024