05D2289987 CLIA NUMBER - 10 ACRE RANCH, INC.

Laboratory Demographics

CLIA Number: 05D2289987

Facility Name: 10 ACRE RANCH, INC.

Facility Address:
8605 JANET AVE
RIVERSIDE, CA
ZIP 92503
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Facility Phone Number: 949 233-3893

Facility Type: Other - INPATIENT SUBSTANCE ABUSE

Certificate Type: Waiver

NPI Number: 1053724716

Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

CLIA Record

Field Name	Field Value
CLIA Number	05D2289987
LAB Type	Other - INPATIENT SUBSTANCE ABUSE
Facility Name	10 ACRE RANCH, INC.
Street	8605 JANET AVE
City	RIVERSIDE
State	CA
ZIP	92503
Phone	949 233-3893
CertificateType	4
CertificateEffectiveDate	9/19/2023
CertificateExpirationDate	9/18/2025
FacilityType	Waiver

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