04D2301620 CLIA NUMBER - TIME WELLNESS AR

Laboratory Demographics

  • CLIA Code: 04D2301620
  • Facility Name: TIME WELLNESS AR
  • Facility Address: 4220 NORTH CROSSOVER RD
    FAYETTEVILLE, AR
    ZIP 72703
  • Facility Phone: 561 860-5582
  • Facility Type: Other - DRUG TREATMENT
  • Facility Type: Waiver
  • Lab Director: DR. MARY E. ELLER
  • NPI Number: 1891575890
  • Taxonomy: 283Q00000X - Psychiatric Hospital

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CLIA Record

Field Name Field Value
CLIA Number 04D2301620
LAB Type Other - DRUG TREATMENT
Facility Name TIME WELLNESS AR
Street 4220 NORTH CROSSOVER RD
City FAYETTEVILLE
State AR
ZIP 72703
Phone 561 860-5582
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/28/2024
Certificate Expiration Date 3/27/2026
Facility Type Other - DRUG TREATMENT
Lab Director DR. MARY E. ELLER

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This page was last updated on: 6/4/2025