45D2136920 CLIA NUMBER - FEDERAL COMP AND WELLNESS

Laboratory Demographics

CLIA Number: 45D2136920

Facility Name: FEDERAL COMP AND WELLNESS

Facility Address:
18817 N HEATHERWILDE BLVD STE 150
PFLUGERVILLE, TX
ZIP 78660
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Facility Phone Number: 512 523-4878

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1497283865

Taxonomy: 207QA0505X - Family Medicine
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.

CLIA Record

Field Name	Field Value
CLIA Number	45D2136920
LAB Type	Physician Office
Facility Name	FEDERAL COMP AND WELLNESS
Street	18817 N HEATHERWILDE BLVD STE 150
City	PFLUGERVILLE
State	TX
ZIP	78660
Phone	512 523-4878
CertificateType	4
CertificateEffectiveDate	9/18/2023
CertificateExpirationDate	9/17/2025
FacilityType	Waiver

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