08D2108657 CLIA NUMBER - MW WELLNESS XI, LLC MEDI-WEIGHTLOSS OF HOCKESSIN

Laboratory Demographics

CLIA Number: 08D2108657

Facility Name: MW WELLNESS XI, LLC MEDI-WEIGHTLOSS OF HOCKESSIN

Facility Address:
304 LANTANA DRIVE
HOCKESSIN, DE
ZIP 19707
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Facility Phone Number: 302 763-3455

Facility Type: Other - WEIGHT LOSS CLINIC

Certificate Type: Waiver

NPI Number: 1649749094

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	08D2108657
LAB Type	Other - WEIGHT LOSS CLINIC
Facility Name	MW WELLNESS XI, LLC MEDI-WEIGHTLOSS OF HOCKESSIN
Street	304 LANTANA DRIVE
City	HOCKESSIN
State	DE
ZIP	19707
Phone	302 763-3455
CertificateType	4
CertificateEffectiveDate	2/9/2024
CertificateExpirationDate	2/8/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024