04D2328422 CLIA NUMBER - WELLQUEST RIVER VALLEY

Laboratory Demographics

CLIA Code: 04D2328422
Facility Name: WELLQUEST RIVER VALLEY
Facility Address: 330 13TH STREET
BARLING, AR
ZIP 72923
Facility Phone: 479 459-3441
Facility Type: Other - PACE CENTER MEDICAL CENTE
Facility Type: Waiver
Lab Director: JAMES H. GOLLEHER
NPI Number: 1447135843
Taxonomy: 251T00000X - Program of All-Inclusive Care for the Elderly (PACE) Provider Organization

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CLIA Record

Field Name	Field Value
CLIA Number	04D2328422
LAB Type	Other - PACE CENTER MEDICAL CENTE
Facility Name	WELLQUEST RIVER VALLEY
Street	330 13TH STREET
City	BARLING
State	AR
ZIP	72923
Phone	479 459-3441
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	8/8/2025
Certificate Expiration Date	8/7/2027
Facility Type	Other - PACE CENTER MEDICAL CENTE
Lab Director	JAMES H. GOLLEHER

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