45D2100110 CLIA NUMBER - VIVIFY WELLNESS CENTER

Laboratory Demographics

  • CLIA Code: 45D2100110
  • Facility Name: VIVIFY WELLNESS CENTER
  • Facility Address: 500 S WESTGATE WAY, SUITE 300
    WYLIE, TX
    ZIP 75098
  • Facility Phone: 972 941-8484
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KENE ANAMEKWE
  • NPI Number: 1811371388
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2100110
LAB Type Physician Office
Facility Name VIVIFY WELLNESS CENTER
Street 500 S WESTGATE WAY, SUITE 300
City WYLIE
State TX
ZIP 75098
Phone 972 941-8484
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/7/2025
Certificate Expiration Date 8/6/2027
Facility Type Physician Office
Lab Director KENE ANAMEKWE

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