05D2188630 CLIA NUMBER - OLA WELLNESS RETREAT

Laboratory Demographics

  • CLIA Code: 05D2188630
  • Facility Name: OLA WELLNESS RETREAT
  • Facility Address: 30425 PACIFIC COAST HWY
    MALIBU, CA
    ZIP 90265
  • Facility Phone: 310 579-5192
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: JASON GILES
  • NPI Number: 1336752963
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2188630
LAB Type Ancillary Testing Site in Health Care Center
Facility Name OLA WELLNESS RETREAT
Street 30425 PACIFIC COAST HWY
City MALIBU
State CA
ZIP 90265
Phone 310 579-5192
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/20/2024
Certificate Expiration Date 7/19/2026
Facility Type Ancillary Testing Site in Health Care Center
Lab Director JASON GILES

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