04D2284065 CLIA NUMBER - WESTSIDE FAMILY CLINIC, LLC

Laboratory Demographics

  • CLIA Code: 04D2284065
  • Facility Name: WESTSIDE FAMILY CLINIC, LLC
  • Facility Address: 3812 W MAIN ST
    RUSSELLVILLE, AR
    ZIP 72801
  • Facility Phone: 479 968-1245
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: ANDREW MONFEE
  • NPI Number: 1801587779
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 04D2284065
LAB Type Physician Office
Facility Name WESTSIDE FAMILY CLINIC, LLC
Street 3812 W MAIN ST
City RUSSELLVILLE
State AR
ZIP 72801
Phone 479 968-1245
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 6/6/2024
Certificate Expiration Date 6/5/2026
Facility Type Physician Office
Lab Director ANDREW MONFEE

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