04D2254924 CLIA NUMBER - DIABETES CARE & WELLNESS DIABETES WELLNESS NP, PLLC, THE

Laboratory Demographics

  • CLIA Code: 04D2254924
  • Facility Name: DIABETES CARE & WELLNESS DIABETES WELLNESS NP, PLLC, THE
  • Facility Address: 512 GRAHAM STREET
    WEST MEMPHIS, AR
    ZIP 72301
  • Facility Phone: 901 249-0755
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: NYKKIA N. SELLERS
  • NPI Number: 1083296057
  • Taxonomy: 261QC1500X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 04D2254924
LAB Type Practitioner Other
Facility Name DIABETES CARE & WELLNESS DIABETES WELLNESS NP, PLLC, THE
Street 512 GRAHAM STREET
City WEST MEMPHIS
State AR
ZIP 72301
Phone 901 249-0755
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/9/2024
Certificate Expiration Date 3/8/2026
Facility Type Practitioner Other
Lab Director NYKKIA N. SELLERS

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