04D0468211 CLIA NUMBER - WHITE RIVER HEALTH FAMILY CARE

Laboratory Demographics

  • CLIA Code: 04D0468211
  • Facility Name: WHITE RIVER HEALTH FAMILY CARE
  • Facility Address: 409 VIRGINIA DR
    BATESVILLE, AR
    ZIP 72501
  • Facility Phone: 870 793-5356
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BOBBI TOSH
  • NPI Number: 1962878207
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D0468211
LAB Type Physician Office
Facility Name WHITE RIVER HEALTH FAMILY CARE
Street 409 VIRGINIA DR
City BATESVILLE
State AR
ZIP 72501
Phone 870 793-5356
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/27/2023
Certificate Expiration Date 10/26/2025
Facility Type Physician Office
Lab Director BOBBI TOSH

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This page was last updated on: 9/29/2025