04D2324551 CLIA NUMBER - ADVANCED WOUND THERAPY - AR LLC

Laboratory Demographics

  • CLIA Code: 04D2324551
  • Facility Name: ADVANCED WOUND THERAPY - AR LLC
  • Facility Address: 593 SOUTH HORSEBARN ROAD
    ROGERS, AR
    ZIP 72758
  • Facility Phone: 479 844-9020
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MATTHEW L. CARMICHAEL
  • NPI Number: 1427854926
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 04D2324551
LAB Type Physician Office
Facility Name ADVANCED WOUND THERAPY - AR LLC
Street 593 SOUTH HORSEBARN ROAD
City ROGERS
State AR
ZIP 72758
Phone 479 844-9020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/27/2025
Certificate Expiration Date 5/26/2027
Facility Type Physician Office
Lab Director MATTHEW L. CARMICHAEL

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