05D2309414 CLIA NUMBER - ELMO DETOX LLC

Laboratory Demographics

  • CLIA Code: 05D2309414
  • Facility Name: ELMO DETOX LLC
  • Facility Address: 4646 ST ELMO BLDG E
    LOS ANGELES, CA
    ZIP 90014
  • Facility Phone: 310 343-8684
  • Facility Type: Other - RECOVERY TREATMENT CTR
  • Facility Type: Waiver
  • Lab Director: BRYAN YANG
  • NPI Number: 1912770975
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2309414
LAB Type Other - RECOVERY TREATMENT CTR
Facility Name ELMO DETOX LLC
Street 4646 ST ELMO BLDG E
City LOS ANGELES
State CA
ZIP 90014
Phone 310 343-8684
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/14/2024
Certificate Expiration Date 8/13/2026
Facility Type Other - RECOVERY TREATMENT CTR
Lab Director BRYAN YANG

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