FOUNTAIN LIFE DALLAS, LLC
NPI 1336829514
Clinic/Center in The Colony, TX
About Fountain Life Dallas, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FOUNTAIN LIFE DALLAS, LLC (NPI 1336829514), doing business as Fountain Life Orlando, Lllc, is a healthcare organization registered as a clinic/center in The Colony, Texas and active in the NPI registry since July 2023. The organization holds a CLIA Waiver certificate valid through December 21, 2026 and lists Barbara Woo, Director Of Clinical Operations, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Other Names 1
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 10D2274017
Fountain Life Orlando LLC · Orlando, FLOther Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1336829514, enumerated as an "organization" on July 21, 2023.
The provider is located at 5762 GRANDSCAPE BLVD STE 115 THE COLONY, TX 75056 and the phone number is (469) 669-0336.
Clinic/Center with taxonomy code 261Q00000X.
