04D1050342 CLIA NUMBER - VAMANA, INC

Laboratory Demographics

  • CLIA Code: 04D1050342
  • Facility Name: VAMANA, INC
  • Facility Address: 422 BEECH ST
    TEXARKANA, AR
    ZIP 71854
  • Facility Phone: 870 773-1111
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: MICHAEL D. BLANKSHIP
  • NPI Number: 1982648267
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D1050342
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name VAMANA, INC
Street 422 BEECH ST
City TEXARKANA
State AR
ZIP 71854
Phone 870 773-1111
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/1/2024
Certificate Expiration Date 1/31/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director MICHAEL D. BLANKSHIP

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