05D2224581 CLIA NUMBER - NEWPORT ACADEMY-RUSH CREEK

Laboratory Demographics

  • CLIA Code: 05D2224581
  • Facility Name: NEWPORT ACADEMY-RUSH CREEK
  • Facility Address: 615 BUGEIA LANE
    NOVATO, CA
    ZIP 94945
  • Facility Phone: 714 393-3523
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: DANA FUTORAN
  • NPI Number: 1467053736
  • Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2224581
LAB Type Comp. Outpatient Rehab Facility
Facility Name NEWPORT ACADEMY-RUSH CREEK
Street 615 BUGEIA LANE
City NOVATO
State CA
ZIP 94945
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 5/13/2025
Certificate Expiration Date 5/12/2027
Facility Type Comp. Outpatient Rehab Facility
Lab Director DANA FUTORAN

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