05D2137490 CLIA NUMBER - ELIM WELLCARE HOSPICE, LLC

Laboratory Demographics

  • CLIA Code: 05D2137490
  • Facility Name: ELIM WELLCARE HOSPICE, LLC
  • Facility Address: 690 WILSHIRE PLACE, STE 307
    LOS ANGELES, CA
    ZIP 90005
  • Facility Phone: 626 793-7511
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: PAULA L. BAILEY-WALTON
  • NPI Number: 1154720522
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2137490
LAB Type Hospice
Facility Name ELIM WELLCARE HOSPICE, LLC
Street 690 WILSHIRE PLACE, STE 307
City LOS ANGELES
State CA
ZIP 90005
Phone 626 793-7511
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/27/2025
Certificate Expiration Date 9/26/2027
Facility Type Hospice
Lab Director PAULA L. BAILEY-WALTON

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