45D2306071 CLIA NUMBER - COLLABORATIVE WELLNESS CENTER, LLC

Laboratory Demographics

  • CLIA Code: 45D2306071
  • Facility Name: COLLABORATIVE WELLNESS CENTER, LLC
  • Facility Address: 1124 GLADE RD STE 140
    COLLEYVILLE, TX
    ZIP 76034
  • Facility Phone: 817 875-8343
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: FLATASHA A. ROLAND
  • NPI Number: 1366942682
  • Taxonomy: 101YP2500X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 45D2306071
LAB Type Practitioner Other
Facility Name COLLABORATIVE WELLNESS CENTER, LLC
Street 1124 GLADE RD STE 140
City COLLEYVILLE
State TX
ZIP 76034
Phone 817 875-8343
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/11/2024
Certificate Expiration Date 6/10/2026
Facility Type Practitioner Other
Lab Director FLATASHA A. ROLAND

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