45D2136104 CLIA NUMBER - LIVINGWELL HEALTHCARE CLINIC

Laboratory Demographics

CLIA Number: 45D2136104

Facility Name: LIVINGWELL HEALTHCARE CLINIC

Facility Address:
912 WRIGHT STREET SUITE A
ARLINGTON, TX
ZIP 76012
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Facility Phone Number: 682 554-7560

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1407330418

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2136104
LAB Type	Community Clinic
Facility Name	LIVINGWELL HEALTHCARE CLINIC
Street	912 WRIGHT STREET SUITE A
City	ARLINGTON
State	TX
ZIP	76012
Phone	682 554-7560
CertificateType	4
CertificateEffectiveDate	9/1/2023
CertificateExpirationDate	8/31/2025
FacilityType	Waiver

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