42D2291101 CLIA NUMBER - WELLNESS INSTITUTE LLC, THE LOTUS AESTHETICS AND THE URGENT CARE

Laboratory Demographics

CLIA Number: 42D2291101

Facility Name: WELLNESS INSTITUTE LLC, THE LOTUS AESTHETICS AND THE URGENT CARE

Facility Address:
507 W PALMETTO STREET
FLORENCE, SC
ZIP 29501
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Facility Phone Number: 843 933-1495

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1831847540

Taxonomy: 101YP2500X - Counselor

CLIA Record

Field Name	Field Value
CLIA Number	42D2291101
LAB Type	Physician Office
Facility Name	WELLNESS INSTITUTE LLC, THE LOTUS AESTHETICS AND THE URGENT CARE
Street	507 W PALMETTO STREET
City	FLORENCE
State	SC
ZIP	29501
Phone	843 933-1495
CertificateType	3
CertificateEffectiveDate	10/5/2023
CertificateExpirationDate	10/4/2025
FacilityType	PPMP

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