05D2286432 CLIA NUMBER - PH WELLNESS

Laboratory Demographics

  • CLIA Code: 05D2286432
  • Facility Name: PH WELLNESS
  • Facility Address: 7635 DUFFERIN AVENUE
    RIVERSIDE, CA
    ZIP 92504
  • Facility Phone: 951 335-5576
  • Facility Type: Other - SUBSTANCE TREATMENT FACIL
  • Facility Type: Waiver
  • Lab Director: JISEUNG YOON
  • NPI Number: 1841957057
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2286432
LAB Type Other - SUBSTANCE TREATMENT FACIL
Facility Name PH WELLNESS
Street 7635 DUFFERIN AVENUE
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 7/28/2025
Certificate Expiration Date 7/27/2027
Facility Type Other - SUBSTANCE TREATMENT FACIL
Lab Director JISEUNG YOON

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