04D0466009 CLIA NUMBER - DEGRAY DIALYSIS

Laboratory Demographics

  • CLIA Code: 04D0466009
  • Facility Name: DEGRAY DIALYSIS
  • Facility Address: 312 PROFESSIONAL PARK DRIVE, SUITE H
    ARKADELPHIA, AR
    ZIP 71923
  • Facility Phone: 870 246-3021
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: MICHAEL S. GERSCH
  • NPI Number: 1467870469
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D0466009
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name DEGRAY DIALYSIS
Street 312 PROFESSIONAL PARK DRIVE, SUITE H
City ARKADELPHIA
State AR
ZIP 71923
Phone 870 246-3021
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/8/2025
Certificate Expiration Date 6/7/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director MICHAEL S. GERSCH

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