45D2293957 CLIA NUMBER - VITALITY WELLNESS CLINIC

Laboratory Demographics

  • CLIA Code: 45D2293957
  • Facility Name: VITALITY WELLNESS CLINIC
  • Facility Address: 6302 W BROADWAY ST SUITE 130
    PEARLAND, TX
    ZIP 77581
  • Facility Phone: 713 213-2717
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: KIMBERLY L. WINGARD
  • NPI Number: 1093320996
  • Taxonomy: 363LF0000X - Nurse Practitioner

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2293957
LAB Type Practitioner Other
Facility Name VITALITY WELLNESS CLINIC
Street 6302 W BROADWAY ST SUITE 130
City PEARLAND
State TX
ZIP 77581
Phone 713 213-2717
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/16/2023
Certificate Expiration Date 11/15/2025
Facility Type Practitioner Other
Lab Director KIMBERLY L. WINGARD

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