05D2285535 CLIA NUMBER - LIBERTY HOUSING SERVICES INC DBA BLUE COAST BEHAVORIAL HEALTH

Laboratory Demographics

  • CLIA Code: 05D2285535
  • Facility Name: LIBERTY HOUSING SERVICES INC DBA BLUE COAST BEHAVORIAL HEALTH
  • Facility Address: 4029 WESTERLY PL STE 101
    NEWPORT BEACH, CA
    ZIP 92660
  • Facility Phone: 714 492-4937
  • Facility Type: Other - BEHAVORIAL HEALTH FACILIT
  • Facility Type: Waiver
  • Lab Director: SANJAI M. THANKACHEN
  • NPI Number: 1548851652
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2285535
LAB Type Other - BEHAVORIAL HEALTH FACILIT
Facility Name LIBERTY HOUSING SERVICES INC DBA BLUE COAST BEHAVORIAL HEALTH
Street 4029 WESTERLY PL STE 101
City NEWPORT BEACH
State CA
ZIP 92660
Phone 714 492-4937
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/13/2025
Certificate Expiration Date 7/12/2027
Facility Type Other - BEHAVORIAL HEALTH FACILIT
Lab Director SANJAI M. THANKACHEN

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