04D2010473 CLIA NUMBER - FAMILY MEDICAL CARE ELANGWE ENTERPRISES

Laboratory Demographics

  • CLIA Code: 04D2010473
  • Facility Name: FAMILY MEDICAL CARE ELANGWE ENTERPRISES
  • Facility Address: 2420 ROGERS AVE
    FORT SMITH, AR
    ZIP 72901
  • Facility Phone: 479 782-0244
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PHILIP ELANGWE
  • NPI Number: 1356662878
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 04D2010473
LAB Type Physician Office
Facility Name FAMILY MEDICAL CARE ELANGWE ENTERPRISES
Street 2420 ROGERS AVE
City FORT SMITH
State AR
ZIP 72901
Phone 479 782-0244
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/28/2024
Certificate Expiration Date 7/27/2026
Facility Type Physician Office
Lab Director PHILIP ELANGWE

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