04D0889664 CLIA NUMBER - JOHN C WAH, MD

Laboratory Demographics

  • CLIA Code: 04D0889664
  • Facility Name: JOHN C WAH, MD
  • Facility Address: 230 WEST BROADWAY
    WEST MEMPHIS, AR
    ZIP 72301
  • Facility Phone: 870 735-8246
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHN C. WAH
  • NPI Number: 1467428847
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 04D0889664
LAB Type Physician Office
Facility Name JOHN C WAH, MD
Street 230 WEST BROADWAY
City WEST MEMPHIS
State AR
ZIP 72301
Phone 870 735-8246
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/2/2024
Certificate Expiration Date 7/1/2026
Facility Type Physician Office
Lab Director JOHN C. WAH

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