05D2079429 CLIA NUMBER - ORANGE COUNTY HEALTH CARE AGENCY JUVENILE HEALTH SERVICES

Laboratory Demographics

  • CLIA Code: 05D2079429
  • Facility Name: ORANGE COUNTY HEALTH CARE AGENCY JUVENILE HEALTH SERVICES
  • Facility Address: 331 THE CITY DRIVE SOUTH
    ORANGE, CA
    ZIP 92868
  • Facility Phone: 714 935-7160
  • Facility Type: Other - JH JUVENILE CAMPS OCFC
  • Facility Type: Microscopy
  • Lab Director: JOANNA SU
  • NPI Number: 1710179049
  • Taxonomy: 2084P0800X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 05D2079429
LAB Type Other - JH JUVENILE CAMPS OCFC
Facility Name ORANGE COUNTY HEALTH CARE AGENCY JUVENILE HEALTH SERVICES
Street 331 THE CITY DRIVE SOUTH
City ORANGE
State CA
ZIP 92868
Phone 714 935-7160
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 6/16/2024
Certificate Expiration Date 6/15/2026
Facility Type Other - JH JUVENILE CAMPS OCFC
Lab Director JOANNA SU

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