10D2278028 CLIA NUMBER - MY WELLNESS NP LLC

Laboratory Demographics

  • CLIA Code: 10D2278028
  • Facility Name: MY WELLNESS NP LLC
  • Facility Address: 20701 JACARANDA RD
    CUTLER BAY, FL
    ZIP 33189
  • Facility Phone: 305 528-3040
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: FANYA S. TOKWAULU
  • NPI Number: 1326755372
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 10D2278028
LAB Type Practitioner Other
Facility Name MY WELLNESS NP LLC
Street 20701 JACARANDA RD
City CUTLER BAY
State FL
ZIP 33189
Phone 305 528-3040
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/9/2025
Certificate Expiration Date 3/8/2027
Facility Type Practitioner Other
Lab Director FANYA S. TOKWAULU

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