04D2143280 CLIA NUMBER - EZECHIEL R NEHUS

Laboratory Demographics

  • CLIA Code: 04D2143280
  • Facility Name: EZECHIEL R NEHUS
  • Facility Address: 200 NORTH QUANAH AVENUE
    RUSSELLVILLE, AR
    ZIP 72801
  • Facility Phone: 479 890-0368
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. EZECHIEL R. NEHUS
  • NPI Number: 1912973306
  • Taxonomy: 207YX0905X - Otolaryngology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 04D2143280
LAB Type Physician Office
Facility Name EZECHIEL R NEHUS
Street 200 NORTH QUANAH AVENUE
City RUSSELLVILLE
State AR
ZIP 72801
Phone 479 890-0368
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/26/2024
Certificate Expiration Date 1/25/2026
Facility Type Physician Office
Lab Director DR. EZECHIEL R. NEHUS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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