04D0466083 CLIA NUMBER - ARCARE 10, AUGUSTA MEDICAL

Laboratory Demographics

CLIA Number: 04D0466083

Facility Name: ARCARE 10, AUGUSTA MEDICAL

Facility Address:
400 HWY 64E
AUGUSTA, AR
ZIP 72006
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Facility Phone Number: 870 347-2534

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1689168643

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	04D0466083
LAB Type	Other
Facility Name	ARCARE 10, AUGUSTA MEDICAL
Street	400 HWY 64E
City	AUGUSTA
State	AR
ZIP	72006
Phone	870 347-2534
CertificateType	4
CertificateEffectiveDate	8/1/2022
CertificateExpirationDate	7/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024