01D0304222 CLIA NUMBER - VITAL HEALTH AND WELLNESS LLC

Laboratory Demographics

  • CLIA Code: 01D0304222
  • Facility Name: VITAL HEALTH AND WELLNESS LLC
  • Facility Address: 2100 CHESTNUT STREET
    MONTGOMERY, AL
    ZIP 36106
  • Facility Phone: 334 264-3434
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BROOKE RICHARDSON
  • NPI Number: 1740276617
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 01D0304222
LAB Type Physician Office
Facility Name VITAL HEALTH AND WELLNESS LLC
Street 2100 CHESTNUT STREET
City MONTGOMERY
State AL
ZIP 36106
Phone 334 264-3434
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/1/2024
Certificate Expiration Date 12/31/2025
Facility Type Physician Office
Lab Director BROOKE RICHARDSON

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: 6/4/2025