05D2279149 CLIA NUMBER - PH WELLNESS

Laboratory Demographics

  • CLIA Code: 05D2279149
  • Facility Name: PH WELLNESS
  • Facility Address: 7603 DUFFERIN AVE
    RIVERSIDE, CA
    ZIP 92504
  • Facility Phone: 951 335-5576
  • Facility Type: Other - SUBSTANCE USE TREATMENT F
  • Facility Type: Waiver
  • Lab Director: JISEUNG YOON
  • NPI Number: 1497414718
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2279149
LAB Type Other - SUBSTANCE USE TREATMENT F
Facility Name PH WELLNESS
Street 7603 DUFFERIN AVE
City RIVERSIDE
State CA
ZIP 92504
Phone 951 335-5576
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/29/2025
Certificate Expiration Date 3/28/2027
Facility Type Other - SUBSTANCE USE TREATMENT F
Lab Director JISEUNG YOON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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