04D2277415 CLIA NUMBER - TRIFECTA CARE LLC

Laboratory Demographics

  • CLIA Code: 04D2277415
  • Facility Name: TRIFECTA CARE LLC
  • Facility Address: 207 FRANKIE LN
    WHITE HALL, AR
    ZIP 71602
  • Facility Phone: 870 395-7122
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: RHONDA COLEMAN
  • NPI Number: 1427833557
  • Taxonomy: 363LA2200X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 04D2277415
LAB Type Practitioner Other
Facility Name TRIFECTA CARE LLC
Street 207 FRANKIE LN
City WHITE HALL
State AR
ZIP 71602
Phone 870 395-7122
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/27/2025
Certificate Expiration Date 2/26/2027
Facility Type Practitioner Other
Lab Director RHONDA COLEMAN

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