05D2275390 CLIA NUMBER - PHOENIX HOUSE ORANGE COUNTY INC

Laboratory Demographics

  • CLIA Code: 05D2275390
  • Facility Name: PHOENIX HOUSE ORANGE COUNTY INC
  • Facility Address: 1207 E FRUIT ST
    SANTA ANA, CA
    ZIP 92701
  • Facility Phone: 818 686-3112
  • Facility Type: Other - SUD RESIDENTIAL/OUTPATIEN
  • Facility Type: Waiver
  • Lab Director: RAYEK NAFIZ
  • NPI Number: 1972809341
  • Taxonomy: 3245S0500X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2275390
LAB Type Other - SUD RESIDENTIAL/OUTPATIEN
Facility Name PHOENIX HOUSE ORANGE COUNTY INC
Street 1207 E FRUIT ST
City SANTA ANA
State CA
ZIP 92701
Phone 818 686-3112
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/20/2025
Certificate Expiration Date 1/19/2027
Facility Type Other - SUD RESIDENTIAL/OUTPATIEN
Lab Director RAYEK NAFIZ

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