04D2299381 CLIA NUMBER - JEFFERSON REGIONAL SPECIALTY HOSPITAL

Laboratory Demographics

  • CLIA Code: 04D2299381
  • Facility Name: JEFFERSON REGIONAL SPECIALTY HOSPITAL
  • Facility Address: 1500 W HOLLAND AVE
    WHITE HALL, AR
    ZIP 71602
  • Facility Phone: 870 930-6500
  • Facility Type: Other - INPATIENT REHAB FACILITY
  • Facility Type: Waiver
  • Lab Director: MS. REBEKAH DAVIS
  • NPI Number: 1053484782
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2299381
LAB Type Other - INPATIENT REHAB FACILITY
Facility Name JEFFERSON REGIONAL SPECIALTY HOSPITAL
Street 1500 W HOLLAND AVE
City WHITE HALL
State AR
ZIP 71602
Phone 870 930-6500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/20/2024
Certificate Expiration Date 2/19/2026
Facility Type Other - INPATIENT REHAB FACILITY
Lab Director MS. REBEKAH DAVIS

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