VITALMEDIX SUPPLIES LLC
NPI 1053109710
Clinical Medical Laboratory in Independence, MO

Active since April 30, 2025CLIA 26D2322769 · Waiver
10616 E WINNER RD, INDEPENDENCE, MO 64052(872) 331-8174 Get Directions Write a Review

NPPES record last updated: April 30, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Vitalmedix Supplies Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VITALMEDIX SUPPLIES LLC (NPI 1053109710) is a healthcare organization registered as a clinical medical laboratory in Independence, Missouri and active in the NPI registry since April 2025. The organization holds a CLIA Waiver certificate valid through April 24, 2027 and lists Unknown Mohammed Mohiuddin Ahmed, Manager/president, as its authorized official.

NPPES Registry Identity

NPI1053109710
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NameVITALMEDIX SUPPLIES LLC
Location Address10616 E WINNER RDIndependence, MO 64052-2203
Mailing Address10616 E 18th St S Ste 402Independence, MO 64052-2203
Organization SubpartYes
Authorized OfficialUnknown Mohammed Mohiuddin AhmedManager/president · (872) 331-8174
Enumeration DateApril 30, 2025
NPPES CertifiedApril 22, 2025
NPI 1053109710 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
Definition
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.
10616 E WINNER RD, Independence, MO 64052

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D2322769

Vitalmedix Supplies LLC · Independence, MO
Active · expires Apr 24, 2027
CLIA Number26D2322769
Laboratory TypeIndependent
Certificate Effective DateApril 25, 2025
Certificate Expiration DateApril 24, 2027
Laboratory DirectorMohammed Mohiuddin Ahmed
Laboratory Phone(872) 331-8174
Laboratory LocationVitalmedix Supplies LLC10616 E Winner Rd, Independence, MO 64052
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vitalmedix Supplies LLC's NPI number?

The NPI number for Vitalmedix Supplies LLC is 1053109710. It was assigned to this organization in the NPPES registry on April 30, 2025.

Where is Vitalmedix Supplies LLC located?

Vitalmedix Supplies LLC is located at 10616 E Winner Rd, Independence, MO 64052. The listed phone number is (872) 331-8174.

What is Vitalmedix Supplies LLC's specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

Does Vitalmedix Supplies LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D2322769) is associated with this NPI, valid through April 24, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Vitalmedix Supplies LLC was last updated on April 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.