An Iranian missile slammed into the main hospital in southern Israel early Thursday, wounding people and causing "extensive damage," according to the medical facility. Israeli media aired footage of blown-out windows and heavy black smoke.

Another missile hit a high-rise building and several other residential buildings in at least two sites near Tel Aviv. At least 40 people were wounded in the attacks, according to Israel's Magen David Adom rescue service.

Israel, meanwhile, carried out strikes on Iran's Arak heavy water reactor, in its latest attack on the country's sprawling nuclear program, on the seventh day of a conflict that began with a surprise wave of Israeli airstrikes targeting military sites, senior officers and nuclear scientists.

Missile hits main hospital in southern Israel

Iran has fired hundreds of missiles and drones at Israel, though most have been shot down by Israel's multi-tiered air defenses, which detect incoming fire and shoot down missiles heading toward population centers and critical infrastructure. Israeli officials acknowledge it is imperfect.

The missile hit the Soroka Medical Center, which has over 1,000 beds and provides services to the approximately 1 million residents of Israel's south.

A hospital statement said several parts of the medical center were damaged and that the emergency room was treating several minor injuries. The hospital was closed to all new patients except for life-threatening cases. It was not immediately clear how many were wounded in the strike.

Israeli Prime Minister Benjamin Netanyahu condemned the attack and vowed a response, saying: "We will exact the full price from the tyrants in Tehran."

Many hospitals in Israel activated emergency plans in the past week, converting underground parking to hospital floors and move patients underground, especially those who are on ventilators or are difficult to move quickly.

'No radiation danger' after strike on reactor

Israel's military said its fighter jets targeted the Arak facility and its reactor core seal to halt it from being used to produce plutonium.

"The strike targeted the component intended for plutonium production, in order to prevent the reactor from being restored and used for nuclear weapons development," the military said. Israel separately claimed to have struck another site around Natanz it described as being related to Iran's nuclear program.

Iranian state TV said there was "no radiation danger whatsoever" from the attack on the Arak site. An Iranian state television reporter, speaking live in the nearby town of Khondab, said the facility had been evacuated and there was no damage to civilian areas around the reactor.

Israel had warned earlier Thursday morning it would attack the facility and urged the public to flee the area.

Iran has long maintained its program is for peaceful purposes. However, it also enriches uranium up to 60%, a short, technical step away from weapons-grade levels of 90%. Iran is the only non-nuclear-weapon state to enrich at that level.

Israel is the only nuclear-armed state in the Middle East but does not acknowledge having such weapons.

The strikes came a day after Iran's supreme leader rejected U.S. calls for surrender and warned that any military involvement by the Americans would cause "irreparable damage to them." Israel had lifted some restrictions on daily life Wednesday, suggesting the missile threat from Iran on its territory was easing.

Already, Israel's campaign has targeted Iran's enrichment site at Natanz, centrifuge workshops around Tehran and a nuclear site in Isfahan. Its strikes have also killed top generals and nuclear scientists.

A Washington-based Iranian human rights group said at least 639 people, including 263 civilians, have been killed in Iran and more than 1,300 wounded. In retaliation, Iran has fired some 400 missiles and hundreds of drones, killing at least 24 people in Israel and wounding hundreds.

Arak had been redesigned to address nuclear concerns

The Arak heavy water reactor is 250 kilometers (155 miles) southwest of Tehran.

Heavy water helps cool nuclear reactors, but it produces plutonium as a byproduct that can potentially be used in nuclear weapons. That would provide Iran another path to the bomb beyond enriched uranium, should it choose to pursue the weapon.

Iran had agreed under its 2015 nuclear deal with world powers to redesign the facility to relieve proliferation concerns.

The reactor became a point of contention after President Donald Trump withdrew from the nuclear deal in 2018. Ali Akbar Salehi, a high-ranking nuclear official in Iran, said in 2019 that Tehran bought extra parts to replace a portion of the reactor that it had poured concrete into to render it unusable under the deal.

Israel, in conducting its strike, signaled it remained concerned the facility could be used to produce plutonium again one day.

"The strike targeted the component intended for plutonium production, in order to prevent the reactor from being restored and used for nuclear weapons development," the Israeli military said in a statement.

The International Atomic Energy Agency, the United Nations' nuclear watchdog, has been urging Israel not to strike Iranian nuclear sites. IAEA inspectors reportedly last visited Arak on May 14.

Due to restrictions Iran imposed on inspectors, the IAEA has said it lost "continuity of knowledge" about Iran's heavy water production -- meaning it could not absolutely verify Tehran's production and stockpile.

As part of negotiations around the 2015 deal, Iran agreed to sell off its heavy water to the West to remain in compliance with the accord's terms. Even the U.S. purchased some 32 tons of heavy water for over $8 million in one deal. That was one issue that drew criticism from opponents to the deal.