05D2160115 CLIA NUMBER - WELLNESS CONGREGATED LIVING FACILITY INC

Laboratory Demographics

  • CLIA Code: 05D2160115
  • Facility Name: WELLNESS CONGREGATED LIVING FACILITY INC
  • Facility Address: 6231 ETHEL AVENUE
    VAN NUYS, CA
    ZIP 91401
  • Facility Phone: 818 782-7276
  • Facility Type: Other - CONGREGATE LIVING FACILIT
  • Facility Type: Waiver
  • Lab Director: SUMAN N. PATEL MD
  • NPI Number: 1023588936
  • Taxonomy: 251J00000X - Nursing Care

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CLIA Record

Field Name Field Value
CLIA Number 05D2160115
LAB Type Other - CONGREGATE LIVING FACILIT
Facility Name WELLNESS CONGREGATED LIVING FACILITY INC
Street 6231 ETHEL AVENUE
City VAN NUYS
State CA
ZIP 91401
Phone 818 782-7276
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/4/2025
Certificate Expiration Date 1/3/2027
Facility Type Other - CONGREGATE LIVING FACILIT
Lab Director SUMAN N. PATEL MD

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