04D0468752 CLIA NUMBER - WEST WASHINGTON COUNTY CLINIC WASHINGTON REGIONAL

Laboratory Demographics

  • CLIA Code: 04D0468752
  • Facility Name: WEST WASHINGTON COUNTY CLINIC WASHINGTON REGIONAL
  • Facility Address: 106 PARK ST
    LINCOLN, AR
    ZIP 72744
  • Facility Phone: 479 824-3196
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: SUSAN FERGUSON
  • NPI Number: 1639282197
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 04D0468752
LAB Type Physician Office
Facility Name WEST WASHINGTON COUNTY CLINIC WASHINGTON REGIONAL
Street 106 PARK ST
City LINCOLN
State AR
ZIP 72744
Phone 479 824-3196
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 11/5/2024
Certificate Expiration Date 11/4/2026
Facility Type Physician Office
Lab Director SUSAN FERGUSON

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