45D2090246 CLIA NUMBER - LONGVIEW WELLNESS CENTER INC (PINE TREE NORTH CLINIC)

Laboratory Demographics

  • CLIA Code: 45D2090246
  • Facility Name: LONGVIEW WELLNESS CENTER INC (PINE TREE NORTH CLINIC)
  • Facility Address: 1761 W LOOP 281
    LONGVIEW, TX
    ZIP 75604
  • Facility Phone: 903 758-2610
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: ANNETTE O. OKPEKI
  • NPI Number: 1932598752
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2090246
LAB Type Federally Qualified Health Center
Facility Name LONGVIEW WELLNESS CENTER INC (PINE TREE NORTH CLINIC)
Street 1761 W LOOP 281
City LONGVIEW
State TX
ZIP 75604
Phone 903 758-2610
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/13/2024
Certificate Expiration Date 5/12/2026
Facility Type Federally Qualified Health Center
Lab Director ANNETTE O. OKPEKI

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