44D2249257 CLIA NUMBER - REVITALIST LAB, LLC

Laboratory Demographics

  • CLIA Code: 44D2249257
  • Facility Name: REVITALIST LAB, LLC
  • Facility Address: 10608 FLICKENGER LANE
    KNOXVILLE, TN
    ZIP 37922
  • Facility Phone: 833 633-1576
  • Facility Type: Independent
  • Facility Type: Accreditation
  • Lab Director: DR. VANDANA A. KUMAR
  • NPI Number: 1073168241
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 44D2249257
LAB Type Independent
Facility Name REVITALIST LAB, LLC
Street 10608 FLICKENGER LANE
City KNOXVILLE
State TN
ZIP 37922
Phone 833 633-1576
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 10/14/2024
Certificate Expiration Date 10/13/2026
Facility Type Independent
Lab Director DR. VANDANA A. KUMAR

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