37D2133295 CLIA NUMBER - VITALITY MEDICAL, LLC

Laboratory Demographics

  • CLIA Code: 37D2133295
  • Facility Name: VITALITY MEDICAL, LLC
  • Facility Address: 209 N OAK STREET
    SALLISAW, OK
    ZIP 74955
  • Facility Phone: 918 503-6276
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JASON T. STANSILL
  • NPI Number: 1023546660
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 37D2133295
LAB Type Physician Office
Facility Name VITALITY MEDICAL, LLC
Street 209 N OAK STREET
City SALLISAW
State OK
ZIP 74955
Phone 918 503-6276
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 Physician Office
Lab Director JASON T. STANSILL

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