18D2288305 CLIA NUMBER - VITALITY WELLNESS INSTITUTE, LLC

Laboratory Demographics

  • CLIA Code: 18D2288305
  • Facility Name: VITALITY WELLNESS INSTITUTE, LLC
  • Facility Address: 214 HIGHWAY 3086
    JENKINS, KY
    ZIP 41537
  • Facility Phone: 606 212-1131
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MR. BENJAMIN L. KISER
  • NPI Number: 1710404892
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 18D2288305
LAB Type Physician Office
Facility Name VITALITY WELLNESS INSTITUTE, LLC
Street 214 HIGHWAY 3086
City JENKINS
State KY
ZIP 41537
Phone 606 212-1131
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/24/2025
Certificate Expiration Date 8/23/2027
Facility Type Physician Office
Lab Director MR. BENJAMIN L. KISER

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