05D2308223 CLIA NUMBER - MISSION PREP HEALTHCARE LLC

Laboratory Demographics

  • CLIA Code: 05D2308223
  • Facility Name: MISSION PREP HEALTHCARE LLC
  • Facility Address: 7082 EAGLE MOUNTIAN ROAD
    BONSALL, CA
    ZIP 92003
  • Facility Phone: 949 313-4709
  • Facility Type: Other - GROUP HOME FACILITY
  • Facility Type: Waiver
  • Lab Director: WILLAIM DODGE
  • NPI Number: 1730929803
  • Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2308223
LAB Type Other - GROUP HOME FACILITY
Facility Name MISSION PREP HEALTHCARE LLC
Street 7082 EAGLE MOUNTIAN ROAD
City BONSALL
State CA
ZIP 92003
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 7/23/2024
Certificate Expiration Date 7/22/2026
Facility Type Other - GROUP HOME FACILITY
Lab Director WILLAIM DODGE

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