05D2307863 CLIA NUMBER - PROFOUND HEALING CENTERS

Laboratory Demographics

  • CLIA Code: 05D2307863
  • Facility Name: PROFOUND HEALING CENTERS
  • Facility Address: 23140 GONZALES DRIVE
    WOODLAND HILLS, CA
    ZIP 91367
  • Facility Phone: 818 770-1839
  • Facility Type: Other - RESIDENTIAL SUD TREATMENT
  • Facility Type: Waiver
  • Lab Director: JASON E. GILES
  • NPI Number: 1962171918
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2307863
LAB Type Other - RESIDENTIAL SUD TREATMENT
Facility Name PROFOUND HEALING CENTERS
Street 23140 GONZALES DRIVE
City WOODLAND HILLS
State CA
ZIP 91367
Phone 818 770-1839
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/16/2024
Certificate Expiration Date 7/15/2026
Facility Type Other - RESIDENTIAL SUD TREATMENT
Lab Director JASON E. GILES

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