05D2220049 CLIA NUMBER - HEARTWOOD HOUSE LLC

Laboratory Demographics

  • CLIA Code: 05D2220049
  • Facility Name: HEARTWOOD HOUSE LLC
  • Facility Address: 8 CIRCLE ROAD
    SAN RAFAEL, CA
    ZIP 94903
  • Facility Phone: 415 419-8816
  • Facility Type: Other - RESID DETOX FACILITY
  • Facility Type: Waiver
  • Lab Director: WILLIAM NELSON
  • NPI Number: 1386269660
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2220049
LAB Type Other - RESID DETOX FACILITY
Facility Name HEARTWOOD HOUSE LLC
Street 8 CIRCLE ROAD
City SAN RAFAEL
State CA
ZIP 94903
Phone 415 419-8816
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/8/2025
Certificate Expiration Date 4/7/2027
Facility Type Other - RESID DETOX FACILITY
Lab Director WILLIAM NELSON

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