04D2023294 CLIA NUMBER - SCARBROUGH CLINIC, THE

Laboratory Demographics

  • CLIA Code: 04D2023294
  • Facility Name: SCARBROUGH CLINIC, THE
  • Facility Address: 1901 N KILLOUGH
    WYNNE, AR
    ZIP 72396
  • Facility Phone: 870 238-8707
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TAD SCARBROUGH
  • NPI Number: 1386743482
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 04D2023294
LAB Type Physician Office
Facility Name SCARBROUGH CLINIC, THE
Street 1901 N KILLOUGH
City WYNNE
State AR
ZIP 72396
Phone 870 238-8707
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2025
Certificate Expiration Date 4/19/2027
Facility Type Physician Office
Lab Director TAD SCARBROUGH

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