05D2131593 CLIA NUMBER - RESTORE DETOX CENTERS

Laboratory Demographics

  • CLIA Code: 05D2131593
  • Facility Name: RESTORE DETOX CENTERS
  • Facility Address: 14099 SKY MOUNTAIN TRAIL
    POWAY, CA
    ZIP 92064
  • Facility Phone: 858 842-4594
  • Facility Type: Other - RESIDENTIAL DETOX
  • Facility Type: Waiver
  • Lab Director: CLARK E. SMITH MD
  • NPI Number: 1669918165
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2131593
LAB Type Other - RESIDENTIAL DETOX
Facility Name RESTORE DETOX CENTERS
Street 14099 SKY MOUNTAIN TRAIL
City POWAY
State CA
ZIP 92064
Phone 858 842-4594
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/1/2025
Certificate Expiration Date 5/31/2027
Facility Type Other - RESIDENTIAL DETOX
Lab Director CLARK E. SMITH MD

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