04D2168223 CLIA NUMBER - OPTIMAL PAIN AND WELLNESS

Laboratory Demographics

  • CLIA Code: 04D2168223
  • Facility Name: OPTIMAL PAIN AND WELLNESS
  • Facility Address: 909 SE 28TH STREET STE 5
    BENTONVILLE, AR
    ZIP 72712
  • Facility Phone: 479 301-2565
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. REGINA E. THURMAN
  • NPI Number: 1487920146
  • Taxonomy: 208100000X - Physical Medicine & Rehabilitation

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CLIA Record

Field Name Field Value
CLIA Number 04D2168223
LAB Type Physician Office
Facility Name OPTIMAL PAIN AND WELLNESS
Street 909 SE 28TH STREET STE 5
City BENTONVILLE
State AR
ZIP 72712
Phone 479 301-2565
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/25/2025
Certificate Expiration Date 6/24/2027
Facility Type Physician Office
Lab Director DR. REGINA E. THURMAN

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