45D0982256 CLIA NUMBER - WILLOW WELLNESS CENTER PA

Laboratory Demographics

  • CLIA Code: 45D0982256
  • Facility Name: WILLOW WELLNESS CENTER PA
  • Facility Address: 820 E FRONT ST
    TYLER, TX
    ZIP 75702
  • Facility Phone: 903 596-0602
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANGELA N. SMITH
  • NPI Number: 1346346335
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D0982256
LAB Type Physician Office
Facility Name WILLOW WELLNESS CENTER PA
Street 820 E FRONT ST
City TYLER
State TX
ZIP 75702
Phone 903 596-0602
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/22/2025
Certificate Expiration Date 1/21/2027
Facility Type Physician Office
Lab Director ANGELA N. SMITH

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This page was last updated on: 3/20/2025