10D2245852 CLIA NUMBER - WELLNESS CLINIC ON WHEELS

Laboratory Demographics

  • CLIA Code: 10D2245852
  • Facility Name: WELLNESS CLINIC ON WHEELS
  • Facility Address: 1747 FORT SMITH BLVD
    DELTONA, FL
    ZIP 32725
  • Facility Phone: 202 834-7722
  • Facility Type: Other - MOBILE CLINIC
  • Facility Type: Waiver
  • Lab Director: EL AGATHE TEMBENG
  • NPI Number: 1750046363
  • Taxonomy: 261QP2300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2245852
LAB Type Other - MOBILE CLINIC
Facility Name WELLNESS CLINIC ON WHEELS
Street 1747 FORT SMITH BLVD
City DELTONA
State FL
ZIP 32725
Phone 202 834-7722
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/17/2023
Certificate Expiration Date 12/16/2025
Facility Type Other - MOBILE CLINIC
Lab Director EL AGATHE TEMBENG

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