04D2127194 CLIA NUMBER - WALNUT RIDGE FAMILY MEDICAL CLINIC NEA RELIANT HEALTHCARE PROFESSIONALS INC

Laboratory Demographics

  • CLIA Code: 04D2127194
  • Facility Name: WALNUT RIDGE FAMILY MEDICAL CLINIC NEA RELIANT HEALTHCARE PROFESSIONALS INC
  • Facility Address: 1045 WEST MAIN STREET, SUITE C
    WALNUT RIDGE, AR
    ZIP 72476
  • Facility Phone: 870 886-8300
  • Facility Type: Practitioner Other
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. GEORGE R. AINSLIE
  • NPI Number: 1003302324
  • Taxonomy: 1223G0001X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 04D2127194
LAB Type Practitioner Other
Facility Name WALNUT RIDGE FAMILY MEDICAL CLINIC NEA RELIANT HEALTHCARE PROFESSIONALS INC
Street 1045 WEST MAIN STREET, SUITE C
City WALNUT RIDGE
State AR
ZIP 72476
Phone 870 886-8300
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 12/15/2024
Certificate Expiration Date 12/14/2026
Facility Type Practitioner Other
Lab Director DR. GEORGE R. AINSLIE

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