05D2051870 CLIA NUMBER - ALTA MIRA RECOVERY PROGRAMS

Laboratory Demographics

  • CLIA Code: 05D2051870
  • Facility Name: ALTA MIRA RECOVERY PROGRAMS
  • Facility Address: 125 BULKLEY AVE
    SAUSALITO, CA
    ZIP 94965
  • Facility Phone: 415 332-1350
  • Facility Type: Other - RESID AOD PROGRAM/DETOX
  • Facility Type: Waiver
  • Lab Director: HELEN DRISCOLL MD
  • NPI Number: 1669764908
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2051870
LAB Type Other - RESID AOD PROGRAM/DETOX
Facility Name ALTA MIRA RECOVERY PROGRAMS
Street 125 BULKLEY AVE
City SAUSALITO
State CA
ZIP 94965
Phone 415 332-1350
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/29/2024
Certificate Expiration Date 9/28/2026
Facility Type Other - RESID AOD PROGRAM/DETOX
Lab Director HELEN DRISCOLL MD

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