04D2314027 CLIA NUMBER - LUNA WELLNESS, PLLC

Laboratory Demographics

  • CLIA Code: 04D2314027
  • Facility Name: LUNA WELLNESS, PLLC
  • Facility Address: 101 GRANT PLACE , SUITE A
    LOWELL, AR
    ZIP 72745
  • Facility Phone: 479 275-3520
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: TAYLOR B. KELAMIS
  • NPI Number: 1902503451
  • Taxonomy: 261QH0100X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 04D2314027
LAB Type Practitioner Other
Facility Name LUNA WELLNESS, PLLC
Street 101 GRANT PLACE , SUITE A
City LOWELL
State AR
ZIP 72745
Phone 479 275-3520
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/12/2024
Certificate Expiration Date 11/11/2026
Facility Type Practitioner Other
Lab Director TAYLOR B. KELAMIS

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