04D1073725 CLIA NUMBER - WESTERN YELL COUNTY MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 04D1073725
  • Facility Name: WESTERN YELL COUNTY MEDICAL CLINIC
  • Facility Address: 310 WEST BROADWAY STREET
    HAVANA, AR
    ZIP 72842
  • Facility Phone: 479 476-2827
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: JOHN R. WESTWOOD
  • NPI Number: 1821166133
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 04D1073725
LAB Type Physician Office
Facility Name WESTERN YELL COUNTY MEDICAL CLINIC
Street 310 WEST BROADWAY STREET
City HAVANA
State AR
ZIP 72842
Phone 479 476-2827
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 1/6/2024
Certificate Expiration Date 1/5/2026
Facility Type Physician Office
Lab Director JOHN R. WESTWOOD

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