04D1087968 CLIA NUMBER - WILLIS CLINIC PLLC

Laboratory Demographics

  • CLIA Code: 04D1087968
  • Facility Name: WILLIS CLINIC PLLC
  • Facility Address: 616 WEST LEE AVE
    OSCEOLA, AR
    ZIP 72370
  • Facility Phone: 870 563-2545
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHERITA D. WILLIS
  • NPI Number: 1174959795
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D1087968
LAB Type Physician Office
Facility Name WILLIS CLINIC PLLC
Street 616 WEST LEE AVE
City OSCEOLA
State AR
ZIP 72370
Phone 870 563-2545
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/14/2024
Certificate Expiration Date 8/13/2026
Facility Type Physician Office
Lab Director SHERITA D. WILLIS

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