04D2166063 CLIA NUMBER - PREMIER PEDIATRICS

Laboratory Demographics

  • CLIA Code: 04D2166063
  • Facility Name: PREMIER PEDIATRICS
  • Facility Address: 5901 RILEY PARK DR, SUITE B
    FORT SMITH, AR
    ZIP 72916
  • Facility Phone: 479 831-2090
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JOSHUA R. WILKINSON
  • NPI Number: 1588121065
  • Taxonomy: 2080A0000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 04D2166063
LAB Type Physician Office
Facility Name PREMIER PEDIATRICS
Street 5901 RILEY PARK DR, SUITE B
City FORT SMITH
State AR
ZIP 72916
Phone 479 831-2090
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/10/2025
Certificate Expiration Date 5/9/2027
Facility Type Physician Office
Lab Director DR. JOSHUA R. WILKINSON

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