04D0696277 CLIA NUMBER - WYNNE PHYSICIANS CLINIC, LLC

Laboratory Demographics

CLIA Number: 04D0696277

Facility Name: WYNNE PHYSICIANS CLINIC, LLC

Facility Address:
710 SOUTH FALLS
WYNNE, AR
ZIP 72396
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Facility Phone Number: 870 238-2321

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1710517677

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	04D0696277
LAB Type	Physician Office
Facility Name	WYNNE PHYSICIANS CLINIC, LLC
Street	710 SOUTH FALLS
City	WYNNE
State	AR
ZIP	72396
Phone	870 238-2321
CertificateType	2
CertificateEffectiveDate	5/11/2024
CertificateExpirationDate	5/10/2026
FacilityType	Compliance

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