44D0687631 CLIA NUMBER - WEST MEMPHIS WELLNESS LLC

Laboratory Demographics

  • CLIA Code: 44D0687631
  • Facility Name: WEST MEMPHIS WELLNESS LLC
  • Facility Address: 800 WEST BROADWAY STREET
    WEST MEMPHIS, AR
    ZIP 72301
  • Facility Phone: 870 735-5174
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JACK H. SMITH
  • NPI Number: 1366089427
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 44D0687631
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name WEST MEMPHIS WELLNESS LLC
Street 800 WEST BROADWAY STREET
City WEST MEMPHIS
State AR
ZIP 72301
Phone 870 735-5174
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director JACK H. SMITH

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