05D2153316 CLIA NUMBER - TELECARE JAY MAHLER RECOVERY CENTER RESIDENTIAL

Laboratory Demographics

  • CLIA Code: 05D2153316
  • Facility Name: TELECARE JAY MAHLER RECOVERY CENTER RESIDENTIAL
  • Facility Address: 15430 FOOTHILL BOULEVARD
    SAN LEANDRO, CA
    ZIP 94578
  • Facility Phone: 510 357-3562
  • Facility Type: Other - RESIDENTAL RECOVERY CTR
  • Facility Type: Waiver
  • Lab Director: EDWARD MAXWELL, MD
  • NPI Number: 1407232564
  • Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2153316
LAB Type Other - RESIDENTAL RECOVERY CTR
Facility Name TELECARE JAY MAHLER RECOVERY CENTER RESIDENTIAL
Street 15430 FOOTHILL BOULEVARD
City SAN LEANDRO
State CA
ZIP 94578
Phone 510 357-3562
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/23/2024
Certificate Expiration Date 8/22/2026
Facility Type Other - RESIDENTAL RECOVERY CTR
Lab Director EDWARD MAXWELL, MD

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