04D0466080 CLIA NUMBER - ALTHEIMER CLINIC

Laboratory Demographics

  • CLIA Code: 04D0466080
  • Facility Name: ALTHEIMER CLINIC
  • Facility Address: 309 SOUTH EDLINE
    ALTHEIMER, AR
    ZIP 72004
  • Facility Phone: 870 766-8411
  • Facility Type: Community Clinic
  • Facility Type: Microscopy
  • Lab Director: DR. MARCUS CROUTHER
  • NPI Number: 1730385105
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D0466080
LAB Type Community Clinic
Facility Name ALTHEIMER CLINIC
Street 309 SOUTH EDLINE
City ALTHEIMER
State AR
ZIP 72004
Phone 870 766-8411
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description 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.
Certificate Effective Date 8/21/2025
Certificate Expiration Date 8/20/2027
Facility Type Community Clinic
Lab Director DR. MARCUS CROUTHER

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