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45D2193493 CLIA NUMBER - LIVE WELL MEDICAL CARE

Laboratory Demographics

CLIA Number: 45D2193493

Facility Name: LIVE WELL MEDICAL CARE

Facility Address:
15 PINE FOREST DRIVE, UNIT 602
SHENANDOAH, TX
ZIP 77384
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Facility Phone Number: 281 819-7869

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1225525843

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

CLIA Record

Field Name Field Value
CLIA Number 45D2193493
LAB Type Physician Office
Facility Name LIVE WELL MEDICAL CARE
Street 15 PINE FOREST DRIVE, UNIT 602
City SHENANDOAH
State TX
ZIP 77384
Phone 281 819-7869
CertificateType 4
CertificateEffectiveDate 9/22/2022
CertificateExpirationDate 9/21/2024
FacilityType Waiver

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