04D0896371 CLIA NUMBER - SOUTHERN PARAMEDIC SERVICES, INC

Laboratory Demographics

  • CLIA Code: 04D0896371
  • Facility Name: SOUTHERN PARAMEDIC SERVICES, INC
  • Facility Address: 903 NORTH FALLS BLVD
    WYNNE, AR
    ZIP 72396
  • Facility Phone: 870 238-2010
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: JERRY A. MEDLIN
  • NPI Number: 1134597206
  • Taxonomy: 122300000X - Dentist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 04D0896371
LAB Type Ambulance
Facility Name SOUTHERN PARAMEDIC SERVICES, INC
Street 903 NORTH FALLS BLVD
City WYNNE
State AR
ZIP 72396
Phone 870 238-2010
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/9/2025
Certificate Expiration Date 1/8/2027
Facility Type Ambulance
Lab Director JERRY A. MEDLIN

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