34D2019856 CLIA NUMBER - MARION WELLNESS AND DISEASE MANAGEMENT

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Laboratory Demographics

CLIA Number: 34D2019856

Facility Name: MARION WELLNESS AND DISEASE MANAGEMENT

Facility Address:
59 GYPSY MOUNTAIN ROAD
MARION, NC
ZIP 28752
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Facility Phone Number: 828 652-8196

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1801190566

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	34D2019856
LAB Type	Practitioner Other
Facility Name	MARION WELLNESS AND DISEASE MANAGEMENT
Street	59 GYPSY MOUNTAIN ROAD
City	MARION
State	NC
ZIP	28752
Phone	828 652-8196
CertificateType	4
CertificateEffectiveDate	2/8/2023
CertificateExpirationDate	2/7/2025
FacilityType	Waiver

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