47D2147562 CLIA NUMBER - NATIONAL LIFE GROUP WELLNESS CENTER

Laboratory Demographics

CLIA Number: 47D2147562

Facility Name: NATIONAL LIFE GROUP WELLNESS CENTER

Facility Address:
1 NATIONAL LIFE DR, M216
MONTPELIER, VT
ZIP 05604
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Facility Phone Number: 480 868-0646

Facility Type: Other - OUTPATIENT

Certificate Type: Waiver

NPI Number: 1780185991

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	47D2147562
LAB Type	Other - OUTPATIENT
Facility Name	NATIONAL LIFE GROUP WELLNESS CENTER
Street	1 NATIONAL LIFE DR, M216
City	MONTPELIER
State	VT
ZIP	05604
Phone	480 868-0646
CertificateType	4
CertificateEffectiveDate	4/23/2024
CertificateExpirationDate	4/22/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024