04D2312011 CLIA NUMBER - HEALTHY CONNECTIONS JESSIEVILLE SD

Laboratory Demographics

  • CLIA Code: 04D2312011
  • Facility Name: HEALTHY CONNECTIONS JESSIEVILLE SD
  • Facility Address: 7900 N HWY 7
    JESSIEVILLE, AR
    ZIP 71949
  • Facility Phone: 888 710-8220
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: SHAWNA M. DEREEMER
  • NPI Number: 1295313609
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2312011
LAB Type Federally Qualified Health Center
Facility Name HEALTHY CONNECTIONS JESSIEVILLE SD
Street 7900 N HWY 7
City JESSIEVILLE
State AR
ZIP 71949
Phone 888 710-8220
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/2/2024
Certificate Expiration Date 10/1/2026
Facility Type Federally Qualified Health Center
Lab Director SHAWNA M. DEREEMER

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