34D2292509 CLIA NUMBER - OTTER HOUSE WELLNESS INC.

Laboratory Demographics

CLIA Number: 34D2292509

Facility Name: OTTER HOUSE WELLNESS INC.

Facility Address:
40 N FRENCH BROAD AVENUE
ASHEVILLE, NC
ZIP 28801
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Facility Phone Number: 770 313-3821

Facility Type: Ancillary Testing Site in Health Care Center

Certificate Type: Waiver

NPI Number: 1043993348

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	34D2292509
LAB Type	Ancillary Testing Site in Health Care Center
Facility Name	OTTER HOUSE WELLNESS INC.
Street	40 N FRENCH BROAD AVENUE
City	ASHEVILLE
State	NC
ZIP	28801
Phone	770 313-3821
CertificateType	4
CertificateEffectiveDate	10/26/2023
CertificateExpirationDate	10/25/2025
FacilityType	Waiver

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