45D2312558 CLIA NUMBER - PRIME WELLNESS CENTER LLC

Laboratory Demographics

  • CLIA Code: 45D2312558
  • Facility Name: PRIME WELLNESS CENTER LLC
  • Facility Address: 6221 CHAPEL HILL BLVD SUITE 300
    PLANO, TX
    ZIP 75093
  • Facility Phone: 469 777-4688
  • Facility Type: Other - PHP AND IOP CENTER
  • Facility Type: Waiver
  • Lab Director: MONICA D. KNOTT
  • NPI Number: 1073371779
  • Taxonomy: 1041C0700X - Social Worker

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CLIA Record

Field Name Field Value
CLIA Number 45D2312558
LAB Type Other - PHP AND IOP CENTER
Facility Name PRIME WELLNESS CENTER LLC
Street 6221 CHAPEL HILL BLVD SUITE 300
City PLANO
State TX
ZIP 75093
Phone 469 777-4688
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/15/2024
Certificate Expiration Date 10/14/2026
Facility Type Other - PHP AND IOP CENTER
Lab Director MONICA D. KNOTT

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