04D0696277 CLIA NUMBER - WYNNE PHYSICIANS CLINIC, LLC

Laboratory Demographics

  • CLIA Code: 04D0696277
  • Facility Name: WYNNE PHYSICIANS CLINIC, LLC
  • Facility Address: 710 SOUTH FALLS
    WYNNE, AR
    ZIP 72396
  • Facility Phone: 870 238-2321
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: BETH BRADSHAW
  • NPI Number: 1710517677
  • Taxonomy: 207Q00000X - Family Medicine

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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
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 5/11/2024
Certificate Expiration Date 5/10/2026
Facility Type Physician Office
Lab Director BETH BRADSHAW

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