44D2205923 CLIA NUMBER - LIFE WELL PHARMACY DBA LIFEWELL HEALTH SERVICES

Laboratory Demographics

  • CLIA Code: 44D2205923
  • Facility Name: LIFE WELL PHARMACY DBA LIFEWELL HEALTH SERVICES
  • Facility Address: 2408 SUSANNAH ST STE 3
    JOHNSON CITY, TN
    ZIP 37601
  • Facility Phone: 423 202-7870
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENELLE V. MUSICK
  • NPI Number: 1366065278
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D2205923
LAB Type Pharmacy
Facility Name LIFE WELL PHARMACY DBA LIFEWELL HEALTH SERVICES
Street 2408 SUSANNAH ST STE 3
City JOHNSON CITY
State TN
ZIP 37601
Phone 423 202-7870
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/16/2024
Certificate Expiration Date 12/15/2026
Facility Type Pharmacy
Lab Director JENELLE V. MUSICK

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This page was last updated on: 9/29/2025