05D2303887 CLIA NUMBER - ELYSIAN HEALTH LLC

Laboratory Demographics

  • CLIA Code: 05D2303887
  • Facility Name: ELYSIAN HEALTH LLC
  • Facility Address: 7966 BEVERLY BLVD SUITE 102
    LOS ANGELES, CA
    ZIP 90048
  • Facility Phone: 855 340-9952
  • Facility Type: Other - SUD OUTPATIENT
  • Facility Type: Waiver
  • Lab Director: RYAN PETERSON
  • NPI Number: 1750122966
  • Taxonomy: 261QM0850X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2303887
LAB Type Other - SUD OUTPATIENT
Facility Name ELYSIAN HEALTH LLC
Street 7966 BEVERLY BLVD SUITE 102
City LOS ANGELES
State CA
ZIP 90048
Phone 855 340-9952
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/2/2024
Certificate Expiration Date 5/1/2026
Facility Type Other - SUD OUTPATIENT
Lab Director RYAN PETERSON

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