04D2296858 CLIA NUMBER - ELITE WELLNESS AND AESTHETICS

Laboratory Demographics

  • CLIA Code: 04D2296858
  • Facility Name: ELITE WELLNESS AND AESTHETICS
  • Facility Address: 6108 SOUTH 31ST STREET
    FORT SMITH, AR
    ZIP 72908
  • Facility Phone: 479 242-9355
  • Facility Type: Other - PRIVATE WELLNESS CLINIC
  • Facility Type: Waiver
  • Lab Director: MS. AMANDA DAY
  • NPI Number: 1780451088
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 04D2296858
LAB Type Other - PRIVATE WELLNESS CLINIC
Facility Name ELITE WELLNESS AND AESTHETICS
Street 6108 SOUTH 31ST STREET
City FORT SMITH
State AR
ZIP 72908
Phone 479 242-9355
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/8/2024
Certificate Expiration Date 1/7/2026
Facility Type Other - PRIVATE WELLNESS CLINIC
Lab Director MS. AMANDA DAY

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