04D1092014 CLIA NUMBER - WHITE RIVER HEALTH FAMILY CARE

Laboratory Demographics

  • CLIA Code: 04D1092014
  • Facility Name: WHITE RIVER HEALTH FAMILY CARE
  • Facility Address: 501 VINE STREET
    NEWARK, AR
    ZIP 72562
  • Facility Phone: 870 799-3299
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MS. CHRISTIE D. WYATT
  • NPI Number: 1467519249
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D1092014
LAB Type Physician Office
Facility Name WHITE RIVER HEALTH FAMILY CARE
Street 501 VINE STREET
City NEWARK
State AR
ZIP 72562
Phone 870 799-3299
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/5/2024
Certificate Expiration Date 1/4/2026
Facility Type Physician Office
Lab Director MS. CHRISTIE D. WYATT

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