04D0467668 CLIA NUMBER - EAST ARKANSAS FAMILY HEALTH CENTER- WEST MEMPHIS

Laboratory Demographics

CLIA Number: 04D0467668

Facility Name: EAST ARKANSAS FAMILY HEALTH CENTER- WEST MEMPHIS

Facility Address:
900 NORTH 7TH STREET
WEST MEMPHIS, AR
ZIP 72301
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Facility Phone Number: 870 735-3842

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1649704156

Taxonomy: 1223G0001X - Dentist
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

CLIA Record

Field Name	Field Value
CLIA Number	04D0467668
LAB Type	Other
Facility Name	EAST ARKANSAS FAMILY HEALTH CENTER- WEST MEMPHIS
Street	900 NORTH 7TH STREET
City	WEST MEMPHIS
State	AR
ZIP	72301
Phone	870 735-3842
CertificateType	4
CertificateEffectiveDate	6/5/2023
CertificateExpirationDate	6/4/2025
FacilityType	Waiver

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