05D2159731 CLIA NUMBER - CLEAR DETOX CENTER

Laboratory Demographics

CLIA Number: 05D2159731

Facility Name: CLEAR DETOX CENTER

Facility Address:
546 HAMILTON STREET
COSTA MESA, CA
ZIP 92627
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Facility Phone Number: 949 200-7555

Facility Type: Other - DETOX

Certificate Type: Waiver

NPI Number: 1356876767

Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

CLIA Record

Field Name	Field Value
CLIA Number	05D2159731
LAB Type	Other - DETOX
Facility Name	CLEAR DETOX CENTER
Street	546 HAMILTON STREET
City	COSTA MESA
State	CA
ZIP	92627
Phone	949 200-7555
CertificateType	4
CertificateEffectiveDate	12/24/2022
CertificateExpirationDate	12/23/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024