05D2269169 CLIA NUMBER - INDAH RECOVERY

Laboratory Demographics

  • CLIA Code: 05D2269169
  • Facility Name: INDAH RECOVERY
  • Facility Address: 35492 DEL REY
    DANA POINT, CA
    ZIP 92624
  • Facility Phone: 949 503-3413
  • Facility Type: Other - SUBSTANCE ABUSE RES DETOX
  • Facility Type: Waiver
  • Lab Director: SANJAI M. THANKACHEN
  • NPI Number: 1417531237
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2269169
LAB Type Other - SUBSTANCE ABUSE RES DETOX
Facility Name INDAH RECOVERY
Street 35492 DEL REY
City DANA POINT
State CA
ZIP 92624
Phone 949 503-3413
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/21/2024
Certificate Expiration Date 9/20/2026
Facility Type Other - SUBSTANCE ABUSE RES DETOX
Lab Director SANJAI M. THANKACHEN

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