05D2310534 CLIA NUMBER - PRIDE DETOX, LLC

Laboratory Demographics

  • CLIA Code: 05D2310534
  • Facility Name: PRIDE DETOX, LLC
  • Facility Address: 3805 E 15TH ST
    LONG BEACH, CA
    ZIP 90804
  • Facility Phone: 866 465-6889
  • Facility Type: Other - SUBSTANCE USE DETOX CENTE
  • Facility Type: Waiver
  • Lab Director: JISEUNG YOON
  • NPI Number: 1003699380
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2310534
LAB Type Other - SUBSTANCE USE DETOX CENTE
Facility Name PRIDE DETOX, LLC
Street 3805 E 15TH ST
City LONG BEACH
State CA
ZIP 90804
Phone 866 465-6889
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/5/2024
Certificate Expiration Date 9/4/2026
Facility Type Other - SUBSTANCE USE DETOX CENTE
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