45D2282762 CLIA NUMBER - GLC WELLNESS CENTER TEXAS LLC

Laboratory Demographics

  • CLIA Code: 45D2282762
  • Facility Name: GLC WELLNESS CENTER TEXAS LLC
  • Facility Address: 777 E WHEATLAND RD SUITE 106
    DUNCANVILLE, TX
    ZIP 75116
  • Facility Phone: 972 685-5094
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DRALVES EDWARDS
  • NPI Number: 1700433653
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 45D2282762
LAB Type Physician Office
Facility Name GLC WELLNESS CENTER TEXAS LLC
Street 777 E WHEATLAND RD SUITE 106
City DUNCANVILLE
State TX
ZIP 75116
Phone 972 685-5094
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/25/2025
Certificate Expiration Date 5/24/2027
Facility Type Physician Office
Lab Director DRALVES EDWARDS

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This page was last updated on: 9/29/2025