04D1017080 CLIA NUMBER - PRIME CARE MEDICAL CLINIC J P WORNOCK MD PA

Laboratory Demographics

  • CLIA Code: 04D1017080
  • Facility Name: PRIME CARE MEDICAL CLINIC J P WORNOCK MD PA
  • Facility Address: 400 S MAIN ST SUITE 100
    SEARCY, AR
    ZIP 72143
  • Facility Phone: 501 279-9000
  • Facility Type: Other
  • Facility Type: Microscopy
  • Lab Director: DR. JOHN P. WORNOCK
  • NPI Number: 1316918576
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D1017080
LAB Type Other
Facility Name PRIME CARE MEDICAL CLINIC J P WORNOCK MD PA
Street 400 S MAIN ST SUITE 100
City SEARCY
State AR
ZIP 72143
Phone 501 279-9000
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/16/2025
Certificate Expiration Date 9/15/2027
Facility Type Other
Lab Director DR. JOHN P. WORNOCK

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