05D2281176 CLIA NUMBER - SILICON VALLEY RECOVERY AND REHABILITATION

Laboratory Demographics

CLIA Number: 05D2281176

Facility Name: SILICON VALLEY RECOVERY AND REHABILITATION

Facility Address:
1762 TECHNOLOGY DRIVE SUITE 110
SAN JOSE, CA
ZIP 95110
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Facility Phone Number: 831 273-4635

Facility Type: Other - SUBS ABUSE DISORDER CLINI

Certificate Type: Waiver

NPI Number: 1972225530

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2281176
LAB Type	Other - SUBS ABUSE DISORDER CLINI
Facility Name	SILICON VALLEY RECOVERY AND REHABILITATION
Street	1762 TECHNOLOGY DRIVE SUITE 110
City	SAN JOSE
State	CA
ZIP	95110
Phone	831 273-4635
CertificateType	4
CertificateEffectiveDate	5/2/2023
CertificateExpirationDate	5/1/2025
FacilityType	Waiver

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