01D2313806 CLIA NUMBER - WELLNESS COLLECTIVE LLC

Laboratory Demographics

  • CLIA Code: 01D2313806
  • Facility Name: WELLNESS COLLECTIVE LLC
  • Facility Address: 960 DOWNTOWNER BLVD
    MOBILE, AL
    ZIP 36609
  • Facility Phone: 251 480-0070
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. SERENA NIMITYONGSKUL
  • NPI Number: 1740984368
  • Taxonomy: 101Y00000X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 01D2313806
LAB Type Physician Office
Facility Name WELLNESS COLLECTIVE LLC
Street 960 DOWNTOWNER BLVD
City MOBILE
State AL
ZIP 36609
Phone 251 480-0070
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/7/2024
Certificate Expiration Date 11/6/2026
Facility Type Physician Office
Lab Director DR. SERENA NIMITYONGSKUL

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