04D0466155 CLIA NUMBER - SALINE MEMORIAL

Laboratory Demographics

  • CLIA Code: 04D0466155
  • Facility Name: SALINE MEMORIAL
  • Facility Address: 1 MEDICAL PARK DRIVE
    BENTON, AR
    ZIP 72015
  • Facility Phone: 501 776-6498
  • Facility Type: Hospital
  • Facility Type: Accreditation
  • Lab Director: DR. AUTUMN L. WYETH
  • NPI Number: 1114950433
  • Taxonomy: 208M00000X - Hospitalist

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CLIA Record

Field Name Field Value
CLIA Number 04D0466155
LAB Type Hospital
Facility Name SALINE MEMORIAL
Street 1 MEDICAL PARK DRIVE
City BENTON
State AR
ZIP 72015
Phone 501 776-6498
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 2/28/2025
Certificate Expiration Date 2/27/2027
Facility Type Hospital
Lab Director DR. AUTUMN L. WYETH

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