04D0685963 CLIA NUMBER - WALNUT RIDGE NURSING AND REHAB WALNUT RIDGE SNF OP LLC

Laboratory Demographics

  • CLIA Code: 04D0685963
  • Facility Name: WALNUT RIDGE NURSING AND REHAB WALNUT RIDGE SNF OP LLC
  • Facility Address: 1500 WEST MAIN
    WALNUT RIDGE, AR
    ZIP 72476
  • Facility Phone: 870 886-9022
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ERICKA MASSEY
  • NPI Number: 1225026800
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 04D0685963
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name WALNUT RIDGE NURSING AND REHAB WALNUT RIDGE SNF OP LLC
Street 1500 WEST MAIN
City WALNUT RIDGE
State AR
ZIP 72476
Phone 870 886-9022
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director ERICKA MASSEY

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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