04D2113564 CLIA NUMBER - SPINE SPECIALTY CLINIC OF ARKANSAS

Laboratory Demographics

  • CLIA Code: 04D2113564
  • Facility Name: SPINE SPECIALTY CLINIC OF ARKANSAS
  • Facility Address: 746 WILBURN ROAD
    HEBER SPRINGS, AR
    ZIP 72543
  • Facility Phone: 501 270-4116
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. AIMEE E. WIDNER
  • NPI Number: 1497100838
  • Taxonomy: 2081P2900X - Physical Medicine & Rehabilitation

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CLIA Record

Field Name Field Value
CLIA Number 04D2113564
LAB Type Physician Office
Facility Name SPINE SPECIALTY CLINIC OF ARKANSAS
Street 746 WILBURN ROAD
City HEBER SPRINGS
State AR
ZIP 72543
Phone 501 270-4116
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/25/2024
Certificate Expiration Date 5/24/2026
Facility Type Physician Office
Lab Director DR. AIMEE E. WIDNER

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