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05D2288403 CLIA NUMBER - CAPISTRANO BEACH RECOVERY

Laboratory Demographics

CLIA Number: 05D2288403

Facility Name: CAPISTRANO BEACH RECOVERY

Facility Address:
27381 SILVER CREEK DR
SAN JUAN CAPISTRANO, CA
ZIP 92675
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Facility Phone Number: 949 388-0112

Facility Type: Other - RESIDENT TREAT FACILITY

Certificate Type: Waiver
NPI Number: 1588092548

Taxonomy: 251300000X - Local Education Agency (LEA)
The term local education agency means a public board of education or other public authority legally constituted within a State to either provide administrative control or direction of, or perform a service function for public schools serving individuals ages 0 - 21 in a state, city, county, township, school district, or other political subdivision including a combination of school districts or counties recognized in a State as an administrative agency for its public schools. An LEA may provide, or employ professional who provide, services to children included in the Individuals with Disabilities Education Act (IDEA), such services may include, but are not limited to, such medical services as physical, occupational, and speech therapy.

CLIA Record

Field Name Field Value
CLIA Number 05D2288403
LAB Type Other - RESIDENT TREAT FACILITY
Facility Name CAPISTRANO BEACH RECOVERY
Street 27381 SILVER CREEK DR
City SAN JUAN CAPISTRANO
State CA
ZIP 92675
Phone 949 388-0112
CertificateType 4
CertificateEffectiveDate 8/24/2023
CertificateExpirationDate 8/23/2025
FacilityType Waiver

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