45D2224588 CLIA NUMBER - WEALTH INFUSION & WELLNESS CLINIC

Laboratory Demographics

CLIA Number: 45D2224588

Facility Name: WEALTH INFUSION & WELLNESS CLINIC

Facility Address:
204 CAPTAINS CT
MANSFIELD, TX
ZIP 76063
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Facility Phone Number: 240 423-9391

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1134792476

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2224588
LAB Type	Physician Office
Facility Name	WEALTH INFUSION & WELLNESS CLINIC
Street	204 CAPTAINS CT
City	MANSFIELD
State	TX
ZIP	76063
Phone	240 423-9391
CertificateType	4
CertificateEffectiveDate	5/13/2023
CertificateExpirationDate	5/12/2025
FacilityType	Waiver

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