45D2206093 CLIA NUMBER - LONGVIEW WELLNESS CENTER, INC

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Laboratory Demographics

CLIA Number: 45D2206093

Facility Name: LONGVIEW WELLNESS CENTER, INC

Facility Address:
825 MEDICAL DR, STE A
TYLER, TX
ZIP 75701
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Facility Phone Number: 903 758-2610

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1558957662

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2206093
LAB Type	Federally Qualified Health Center
Facility Name	LONGVIEW WELLNESS CENTER, INC
Street	825 MEDICAL DR, STE A
City	TYLER
State	TX
ZIP	75701
Phone	903 758-2610
CertificateType	4
CertificateEffectiveDate	12/17/2022
CertificateExpirationDate	12/16/2024
FacilityType	Waiver

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