05D2307692 CLIA NUMBER - MISSION PREP HEALTHCARE LLC

Laboratory Demographics

  • CLIA Code: 05D2307692
  • Facility Name: MISSION PREP HEALTHCARE LLC
  • Facility Address: 4045 LIMBER PINE RD
    FALLBROOK, CA
    ZIP 92028
  • Facility Phone: 949 313-4709
  • Facility Type: Other - GROUP HOME FACILITY
  • Facility Type: Waiver
  • Lab Director: WILLIAM DODGE
  • NPI Number: 1710727896
  • Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2307692
LAB Type Other - GROUP HOME FACILITY
Facility Name MISSION PREP HEALTHCARE LLC
Street 4045 LIMBER PINE RD
City FALLBROOK
State CA
ZIP 92028
Phone 949 313-4709
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/12/2024
Certificate Expiration Date 7/11/2026
Facility Type Other - GROUP HOME FACILITY
Lab Director WILLIAM DODGE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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