05D2317237 CLIA NUMBER - CASTLEGATE DBA HUNTINGTON BEACH MENTAL HEALTH

Laboratory Demographics

CLIA Code: 05D2317237
Facility Name: CASTLEGATE DBA HUNTINGTON BEACH MENTAL HEALTH
Facility Address: 11640 WARNER AVE STE 542
FOUNTAIN VALLEY, CA
ZIP 92708
Facility Phone: 714 475-1617
Facility Type: Ancillary Testing Site in Health Care Center
Facility Type: Waiver
Lab Director: SANJAI THANKACHEN
NPI Number: 1386326478
Taxonomy: 320800000X - Community Based Residential Treatment Facility, Mental Illness

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CLIA Record

Field Name	Field Value
CLIA Number	05D2317237
LAB Type	Ancillary Testing Site in Health Care Center
Facility Name	CASTLEGATE DBA HUNTINGTON BEACH MENTAL HEALTH
Street	11640 WARNER AVE STE 542
City	FOUNTAIN VALLEY
State	CA
ZIP	92708
Phone	714 475-1617
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	1/21/2025
Certificate Expiration Date	1/20/2027
Facility Type	Ancillary Testing Site in Health Care Center
Lab Director	SANJAI THANKACHEN

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