19D1031097 CLIA NUMBER - WELLNESS EXPRESS LLC

Laboratory Demographics

CLIA Number: 19D1031097

Facility Name: WELLNESS EXPRESS LLC

Facility Address:
207 N LUKE ST
LAFAYETTE, LA
ZIP 70506
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Facility Phone Number: 337 988-1138

Facility Type: Health Fair

Certificate Type: Waiver

NPI Number: 1205163490

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	19D1031097
LAB Type	Health Fair
Facility Name	WELLNESS EXPRESS LLC
Street	207 N LUKE ST
City	LAFAYETTE
State	LA
ZIP	70506
Phone	337 988-1138
CertificateType	4
CertificateEffectiveDate	9/23/2022
CertificateExpirationDate	9/22/2024
FacilityType	Waiver

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