34D2171936 CLIA NUMBER - WELLNESS FOR LIFE, PLLC

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Laboratory Demographics

CLIA Number: 34D2171936

Facility Name: WELLNESS FOR LIFE, PLLC

Facility Address:
648 ALMONDRIDGE DRIVE
STANLEYVILLE, NC
ZIP 27045
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Facility Phone Number: 336 407-2754

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1922659416

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	34D2171936
LAB Type	Physician Office
Facility Name	WELLNESS FOR LIFE, PLLC
Street	648 ALMONDRIDGE DRIVE
City	STANLEYVILLE
State	NC
ZIP	27045
Phone	336 407-2754
CertificateType	4
CertificateEffectiveDate	9/11/2023
CertificateExpirationDate	9/10/2025
FacilityType	Waiver

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