04D2320788 CLIA NUMBER - HEALTH-WISE PHARMACY OF LAVACA HNK PHARM, PLLC

Laboratory Demographics

  • CLIA Code: 04D2320788
  • Facility Name: HEALTH-WISE PHARMACY OF LAVACA HNK PHARM, PLLC
  • Facility Address: 1800 WEST MAIN STREET
    LAVACA, AR
    ZIP 72941
  • Facility Phone: 479 674-2222
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HEATH N. BRANSCUM
  • NPI Number: 1407356678
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2320788
LAB Type Pharmacy
Facility Name HEALTH-WISE PHARMACY OF LAVACA HNK PHARM, PLLC
Street 1800 WEST MAIN STREET
City LAVACA
State AR
ZIP 72941
Phone 479 674-2222
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2025
Certificate Expiration Date 3/23/2027
Facility Type Pharmacy
Lab Director HEATH N. BRANSCUM

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