04D2231550 CLIA NUMBER - TOTAL ACCESS HEALTH AND WELLNESS

Laboratory Demographics

CLIA Number: 04D2231550

Facility Name: TOTAL ACCESS HEALTH AND WELLNESS

Facility Address:
3809 EAST 9TH ST STE 15
TEXARKANA, AR
ZIP 71854
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Facility Phone Number: 903 556-5221

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1386214872

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	04D2231550
LAB Type	Physician Office
Facility Name	TOTAL ACCESS HEALTH AND WELLNESS
Street	3809 EAST 9TH ST STE 15
City	TEXARKANA
State	AR
ZIP	71854
Phone	903 556-5221
CertificateType	4
CertificateEffectiveDate	8/4/2023
CertificateExpirationDate	8/3/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024