39D2270458 CLIA NUMBER - FOSTER HILL WELLNESS DBA MALIBU WELLNESS RANCH

Laboratory Demographics

  • CLIA Code: 39D2270458
  • Facility Name: FOSTER HILL WELLNESS DBA MALIBU WELLNESS RANCH
  • Facility Address: 115 SAINT VINCENT DRIVE
    MILFORD, PA
    ZIP 18337
  • Facility Phone: 570 296-7281
  • Facility Type: Other - IN PATIENT DRUG & ALCO RE
  • Facility Type: Waiver
  • Lab Director: DR. CRAIG T. HAYTMANEK
  • NPI Number: 1437713591
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 39D2270458
LAB Type Other - IN PATIENT DRUG & ALCO RE
Facility Name FOSTER HILL WELLNESS DBA MALIBU WELLNESS RANCH
Street 115 SAINT VINCENT DRIVE
City MILFORD
State PA
ZIP 18337
Phone 570 296-7281
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/17/2024
Certificate Expiration Date 10/16/2026
Facility Type Other - IN PATIENT DRUG & ALCO RE
Lab Director DR. CRAIG T. HAYTMANEK

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