05D2137490 CLIA NUMBER - ELIM WELLCARE HOSPICE, LLC

Laboratory Demographics

CLIA Number: 05D2137490

Facility Name: ELIM WELLCARE HOSPICE, LLC

Facility Address:
690 WILSHIRE PLACE, STE 307
LOS ANGELES, CA
ZIP 90005
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Facility Phone Number: 626 793-7511

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1154720522

Taxonomy: 251G00000X - Hospice Care, Community Based

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
CertificateType	4
CertificateEffectiveDate	9/27/2023
CertificateExpirationDate	9/26/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024