04D2044456 CLIA NUMBER - WASHINGTON REGIONAL INTERNAL MEDICINE ASSOCIATES

Laboratory Demographics

  • CLIA Code: 04D2044456
  • Facility Name: WASHINGTON REGIONAL INTERNAL MEDICINE ASSOCIATES
  • Facility Address: 688 EAST MILLSAP, SUITE 100
    FAYETTEVILLE, AR
    ZIP 72703
  • Facility Phone: 479 463-3070
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ALLISON M. JOHNSON
  • NPI Number: 1598715302
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 04D2044456
LAB Type Physician Office
Facility Name WASHINGTON REGIONAL INTERNAL MEDICINE ASSOCIATES
Street 688 EAST MILLSAP, SUITE 100
City FAYETTEVILLE
State AR
ZIP 72703
Phone 479 463-3070
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 7/25/2024
Certificate Expiration Date 7/24/2026
Facility Type Physician Office
Lab Director ALLISON M. JOHNSON

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