05D2076223 CLIA NUMBER - BAYSIDE MARIN

Laboratory Demographics

  • CLIA Code: 05D2076223
  • Facility Name: BAYSIDE MARIN
  • Facility Address: 191 BAYVIEW DR
    SAN RAFAEL, CA
    ZIP 94901
  • Facility Phone: 415 450-9242
  • Facility Type: Other - DRUG & ALCOHOL RESIDENTIA
  • Facility Type: Waiver
  • Lab Director: ERIC KHOURY
  • NPI Number: 1801041074
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2076223
LAB Type Other - DRUG & ALCOHOL RESIDENTIA
Facility Name BAYSIDE MARIN
Street 191 BAYVIEW DR
City SAN RAFAEL
State CA
ZIP 94901
Phone 415 450-9242
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/14/2024
Certificate Expiration Date 4/13/2026
Facility Type Other - DRUG & ALCOHOL RESIDENTIA
Lab Director ERIC KHOURY

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