45D2220291 CLIA NUMBER - VITALITY PEDIATRIC HEALTHCARE, LLC

Laboratory Demographics

  • CLIA Code: 45D2220291
  • Facility Name: VITALITY PEDIATRIC HEALTHCARE, LLC
  • Facility Address: 3822 BASTROP ST
    MELISSA, TX
    ZIP 75454
  • Facility Phone: 469 301-7602
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: GEORGE EYAKOH
  • NPI Number: 1275147308
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 45D2220291
LAB Type Home Health Agency
Facility Name VITALITY PEDIATRIC HEALTHCARE, LLC
Street 3822 BASTROP ST
City MELISSA
State TX
ZIP 75454
Phone 469 301-7602
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/12/2025
Certificate Expiration Date 4/11/2027
Facility Type Home Health Agency
Lab Director GEORGE EYAKOH

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