03D2279502 CLIA NUMBER - NEW LIVING WELLNESS LLC

Laboratory Demographics

  • CLIA Code: 03D2279502
  • Facility Name: NEW LIVING WELLNESS LLC
  • Facility Address: 1209 N COUNTRY CLUB DR STE 1
    MESA, AZ
    ZIP 85201
  • Facility Phone: 623 256-8098
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER POCLITAR
  • NPI Number: 1154024180
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2279502
LAB Type Comp. Outpatient Rehab Facility
Facility Name NEW LIVING WELLNESS LLC
Street 1209 N COUNTRY CLUB DR STE 1
City MESA
State AZ
ZIP 85201
Phone 623 256-8098
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/3/2023
Certificate Expiration Date 4/2/2025
Facility Type Comp. Outpatient Rehab Facility
Lab Director CHRISTOPHER POCLITAR

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This page was last updated on: 3/20/2025