04D2291283 CLIA NUMBER - VITALITY PLUS INFUSION CENTER LLC

Laboratory Demographics

  • CLIA Code: 04D2291283
  • Facility Name: VITALITY PLUS INFUSION CENTER LLC
  • Facility Address: 19 MEDICAL PLAZA SUITE 30
    MOUNTAIN HOME, AR
    ZIP 72653
  • Facility Phone: 870 232-0885
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. WILLIAM C. SMITH
  • NPI Number: 1356121461
  • Taxonomy: 261QI0500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2291283
LAB Type Physician Office
Facility Name VITALITY PLUS INFUSION CENTER LLC
Street 19 MEDICAL PLAZA SUITE 30
City MOUNTAIN HOME
State AR
ZIP 72653
Phone 870 232-0885
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/9/2023
Certificate Expiration Date 10/8/2025
Facility Type Physician Office
Lab Director DR. WILLIAM C. SMITH

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