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LAVACA WELLNESS CLINIC, P.A.
NPI 1821390287
Clinic/Center - Primary Care in Lavaca, AR

Active since November 17, 2010CLIA 04D2172054 · Microscopy
603 S DIVISION ST, LAVACA, AR 72941(479) 674-9181(479) 674-8105 Get Directions Write a Review

NPPES record last updated: November 17, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Lavaca Wellness Clinic, P.a. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAVACA WELLNESS CLINIC, P.A. (NPI 1821390287) is a healthcare organization registered as a primary care in Lavaca, Arkansas and active in the NPI registry since November 2010. The organization holds a CLIA Microscopy certificate valid through September 12, 2027 and lists Robert E. Sanders, Owner, as its authorized official.

NPPES Registry Identity

NPI1821390287
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameLAVACA WELLNESS CLINIC, P.A.
Location Address603 S DIVISION STLavaca, AR 72941-4129
Mailing Address603 S Division StLavaca, AR 72941-4129 · (479) 674-9181 · Fax (479) 674-8105
Phone(479) 674-9181
Fax(479) 674-8105
Organization SubpartNo
Authorized OfficialRobert E. SandersOwner · (479) 462-7203
Enumeration DateNovember 17, 2010
✔ NPI 1821390287 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
603 S DIVISION ST, Lavaca, AR 72941
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 04D2172054

Lavaca Wellness Center · Lavaca, AR
Active · expires Sep 12, 2027
CLIA Number04D2172054
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateSeptember 13, 2025
Certificate Expiration DateSeptember 12, 2027
Laboratory DirectorKelly Hubbard
Laboratory Phone(479) 279-7700
Laboratory LocationLavaca Wellness Center603 S Division St, Lavaca, AR 72941
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JONATHAN RENE BRONISTE APN
Nurse Practitioner
603 S DIVISION ST
LAVACA, AR 72941
Sebastian County (479) 674-9181
RIVER VALLEY PRIMARY CARE SERVICES
Clinic/Center (Dental)
603 S DIVISION ST
LAVACA, AR 72941
Sebastian County (479) 279-7683
KELLY JO HUBBARD APN
Nurse Practitioner (Family)
603 S DIVISION ST
LAVACA, AR 72941
Sebastian County (479) 279-7700
RIVER VALLEY PRIMARY CARE SERVICES
Clinic/Center (Federally Qualified Health Center (FQHC))
603 S DIVISION ST
LAVACA, AR 72941
Sebastian County (479) 431-2050

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lavaca Wellness Clinic, P.A.'s NPI number?

The NPI number for Lavaca Wellness Clinic, P.A. is 1821390287. It was assigned to this organization in the NPPES registry on November 17, 2010.

Where is Lavaca Wellness Clinic, P.A. located?

Lavaca Wellness Clinic, P.A. is located at 603 S Division St, Lavaca, AR 72941. The listed phone number is (479) 674-9181.

What is Lavaca Wellness Clinic, P.A.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Lavaca Wellness Clinic, P.A. hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 04D2172054) is associated with this NPI, valid through September 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lavaca Wellness Clinic, P.A. was last updated on November 17, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.