45D2027816 CLIA NUMBER - MW WELLNESS VI, LLC

Laboratory Demographics

  • CLIA Code: 45D2027816
  • Facility Name: MW WELLNESS VI, LLC
  • Facility Address: 3500 VICTORY GROUP WAY SUITE 300
    FRISCO, TX
    ZIP 75034
  • Facility Phone: 972 381-9300
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHRIS GUY YIANTSOU
  • NPI Number: 1124558861
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2027816
LAB Type Physician Office
Facility Name MW WELLNESS VI, LLC
Street 3500 VICTORY GROUP WAY SUITE 300
City FRISCO
State TX
ZIP 75034
Phone 972 381-9300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/2/2023
Certificate Expiration Date 8/1/2025
Facility Type Physician Office
Lab Director CHRIS GUY YIANTSOU

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