05D2121046 CLIA NUMBER - TRUE LIFE RECOVERY, INC.

Laboratory Demographics

  • CLIA Code: 05D2121046
  • Facility Name: TRUE LIFE RECOVERY, INC.
  • Facility Address: 16832 MAPLE ST
    FOUNTAIN VALLEY, CA
    ZIP 92708
  • Facility Phone: 714 698-8950
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: SANJAI THANKACHEN
  • NPI Number: 1922459551
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2121046
LAB Type Comp. Outpatient Rehab Facility
Facility Name TRUE LIFE RECOVERY, INC.
Street 16832 MAPLE ST
City FOUNTAIN VALLEY
State CA
ZIP 92708
Phone 714 698-8950
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2024
Certificate Expiration Date 10/27/2026
Facility Type Comp. Outpatient Rehab Facility
Lab Director SANJAI THANKACHEN

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This page was last updated on: 6/4/2025