08D2302596 CLIA NUMBER - OLIVE BRANCH INTEGRATIVE MENTAL WELLNESS, LLC

Laboratory Demographics

  • CLIA Code: 08D2302596
  • Facility Name: OLIVE BRANCH INTEGRATIVE MENTAL WELLNESS, LLC
  • Facility Address: 31 GOODEN AVE
    DOVER, DE
    ZIP 19904
  • Facility Phone: 302 249-2648
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: MORGAN WEBB
  • NPI Number: 1790472124
  • Taxonomy: 363LP0808X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 08D2302596
LAB Type Practitioner Other
Facility Name OLIVE BRANCH INTEGRATIVE MENTAL WELLNESS, LLC
Street 31 GOODEN AVE
City DOVER
State DE
ZIP 19904
Phone 302 249-2648
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/12/2024
Certificate Expiration Date 4/11/2026
Facility Type Practitioner Other
Lab Director MORGAN WEBB

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