04D2009224 CLIA NUMBER - RIVER RIDGE REHAB-CARE CTR CROSS SNF OPERATIONS LLC

Laboratory Demographics

  • CLIA Code: 04D2009224
  • Facility Name: RIVER RIDGE REHAB-CARE CTR CROSS SNF OPERATIONS LLC
  • Facility Address: 1100 EAST MARTIN
    WYNNE, AR
    ZIP 72396
  • Facility Phone: 870 238-4400
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MINCIE THOMAS
  • NPI Number: 1902114192
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 04D2009224
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name RIVER RIDGE REHAB-CARE CTR CROSS SNF OPERATIONS LLC
Street 1100 EAST MARTIN
City WYNNE
State AR
ZIP 72396
Phone 870 238-4400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/29/2024
Certificate Expiration Date 6/28/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director MINCIE THOMAS

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