04D2313983 CLIA NUMBER - LAKE TOWN WELLNESS, LIMITED

Laboratory Demographics

  • CLIA Code: 04D2313983
  • Facility Name: LAKE TOWN WELLNESS, LIMITED
  • Facility Address: 1031 HWY 25B, SUITE 1
    HEBER SPRINGS, AR
    ZIP 72543
  • Facility Phone: 501 436-2620
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: STEPHANIE M. THOMPSON
  • NPI Number: 1578375952
  • Taxonomy: 363LF0000X - Nurse Practitioner

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 04D2313983
LAB Type Practitioner Other
Facility Name LAKE TOWN WELLNESS, LIMITED
Street 1031 HWY 25B, SUITE 1
City HEBER SPRINGS
State AR
ZIP 72543
Phone 501 436-2620
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/12/2024
Certificate Expiration Date 11/11/2026
Facility Type Practitioner Other
Lab Director STEPHANIE M. THOMPSON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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