04D2274442 CLIA NUMBER - WANDA CAROL TOWNSEND APRN LLC

Laboratory Demographics

  • CLIA Code: 04D2274442
  • Facility Name: WANDA CAROL TOWNSEND APRN LLC
  • Facility Address: 5150B SR 247
    POTTSVILLE, AR
    ZIP 72858
  • Facility Phone: 479 567-5680
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: WANDA C. TOWNSEND
  • NPI Number: 1740906031
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 04D2274442
LAB Type Practitioner Other
Facility Name WANDA CAROL TOWNSEND APRN LLC
Street 5150B SR 247
City POTTSVILLE
State AR
ZIP 72858
Phone 479 567-5680
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/4/2025
Certificate Expiration Date 1/3/2027
Facility Type Practitioner Other
Lab Director WANDA C. TOWNSEND

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