45D2313267 CLIA NUMBER - WELLNESS BAY LLC

Laboratory Demographics

  • CLIA Code: 45D2313267
  • Facility Name: WELLNESS BAY LLC
  • Facility Address: 4887-1 WILLIAMS DRIVE, STE 107
    GEORGETOWN, TX
    ZIP 78633
  • Facility Phone: 424 302-8720
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MOHAMMAD AL DARAWSHA MD
  • NPI Number: 1407676737
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2313267
LAB Type Physician Office
Facility Name WELLNESS BAY LLC
Street 4887-1 WILLIAMS DRIVE, STE 107
City GEORGETOWN
State TX
ZIP 78633
Phone 424 302-8720
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2024
Certificate Expiration Date 10/27/2026
Facility Type Physician Office
Lab Director MOHAMMAD AL DARAWSHA MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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