04D2285257 CLIA NUMBER - VIVE INFUSION AND WELLNESS

Laboratory Demographics

  • CLIA Code: 04D2285257
  • Facility Name: VIVE INFUSION AND WELLNESS
  • Facility Address: 3410 E JOHNSON AVE, STE Z
    JONESBORO, AR
    ZIP 72405
  • Facility Phone: 870 336-1216
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: CARRIE TATE
  • NPI Number: 1467164095
  • Taxonomy: 261QI0500X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 04D2285257
LAB Type Practitioner Other
Facility Name VIVE INFUSION AND WELLNESS
Street 3410 E JOHNSON AVE, STE Z
City JONESBORO
State AR
ZIP 72405
Phone 870 336-1216
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/10/2025
Certificate Expiration Date 7/9/2027
Facility Type Practitioner Other
Lab Director CARRIE TATE

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