05D2310730 CLIA NUMBER - PALM AVE DETOX

Laboratory Demographics

  • CLIA Code: 05D2310730
  • Facility Name: PALM AVE DETOX
  • Facility Address: 2251 PALM AVE
    SAN MATEO, CA
    ZIP 94403
  • Facility Phone: 209 603-3915
  • Facility Type: Other - DHCS SUD TREATMENT PROGRA
  • Facility Type: Waiver
  • Lab Director: BELIS ALADAG
  • NPI Number: 1689961617
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2310730
LAB Type Other - DHCS SUD TREATMENT PROGRA
Facility Name PALM AVE DETOX
Street 2251 PALM AVE
City SAN MATEO
State CA
ZIP 94403
Phone 209 603-3915
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/9/2024
Certificate Expiration Date 9/8/2026
Facility Type Other - DHCS SUD TREATMENT PROGRA
Lab Director BELIS ALADAG

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