04D2281704 CLIA NUMBER - JEFFERSON REGIONAL NEPHROLOGY ASSOCIATES

Laboratory Demographics

  • CLIA Code: 04D2281704
  • Facility Name: JEFFERSON REGIONAL NEPHROLOGY ASSOCIATES
  • Facility Address: 1420 WEST 43RD AVENUE SUITE A
    PINE BLUFF, AR
    ZIP 71603
  • Facility Phone: 870 541-6020
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. BRANDI WRIGHT
  • NPI Number: 1023005550
  • Taxonomy: 207L00000X - Anesthesiology

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CLIA Record

Field Name Field Value
CLIA Number 04D2281704
LAB Type Physician Office
Facility Name JEFFERSON REGIONAL NEPHROLOGY ASSOCIATES
Street 1420 WEST 43RD AVENUE SUITE A
City PINE BLUFF
State AR
ZIP 71603
Phone 870 541-6020
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 5/10/2025
Certificate Expiration Date 5/9/2027
Facility Type Physician Office
Lab Director DR. BRANDI WRIGHT

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