05D2159463 CLIA NUMBER - NEWPORT ACADEMY-REDWOOD

Laboratory Demographics

  • CLIA Code: 05D2159463
  • Facility Name: NEWPORT ACADEMY-REDWOOD
  • Facility Address: 16 MEADOW VIEW LN
    SAN GERONIMO, CA
    ZIP 94963
  • Facility Phone: 714 393-3523
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: DANA FUTORAN
  • NPI Number: 1942790241
  • Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2159463
LAB Type Comp. Outpatient Rehab Facility
Facility Name NEWPORT ACADEMY-REDWOOD
Street 16 MEADOW VIEW LN
City SAN GERONIMO
State CA
ZIP 94963
Phone 714 393-3523
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2024
Certificate Expiration Date 12/18/2026
Facility Type Comp. Outpatient Rehab Facility
Lab Director DANA FUTORAN

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