05D2297043 CLIA NUMBER - AMHS TELECARE TREEHOUSE CRISIS RESIDENTIAL-SOUTH

Laboratory Demographics

  • CLIA Code: 05D2297043
  • Facility Name: AMHS TELECARE TREEHOUSE CRISIS RESIDENTIAL-SOUTH
  • Facility Address: 25402 PACIFICA AVE
    MISSION VIEJO, CA
    ZIP 92691
  • Facility Phone: 949 238-2400
  • Facility Type: Other - CRISIS RESIDENTIAL
  • Facility Type: Waiver
  • Lab Director: RICHARD GRANESE
  • NPI Number: 1942737648
  • Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2297043
LAB Type Other - CRISIS RESIDENTIAL
Facility Name AMHS TELECARE TREEHOUSE CRISIS RESIDENTIAL-SOUTH
Street 25402 PACIFICA AVE
City MISSION VIEJO
State CA
ZIP 92691
Phone 949 238-2400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/10/2024
Certificate Expiration Date 1/9/2026
Facility Type Other - CRISIS RESIDENTIAL
Lab Director RICHARD GRANESE

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