04D0466158 CLIA NUMBER - FAMILY PRACTICE ASSOCIATES PROSPECTIVE HEALTH LTD

Laboratory Demographics

  • CLIA Code: 04D0466158
  • Facility Name: FAMILY PRACTICE ASSOCIATES PROSPECTIVE HEALTH LTD
  • Facility Address: 1304 MILITARY RD
    BENTON, AR
    ZIP 72015
  • Facility Phone: 501 778-0934
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. LISA R. BARKER
  • NPI Number: 1114058682
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 04D0466158
LAB Type Physician Office
Facility Name FAMILY PRACTICE ASSOCIATES PROSPECTIVE HEALTH LTD
Street 1304 MILITARY RD
City BENTON
State AR
ZIP 72015
Phone 501 778-0934
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 9/16/2024
Certificate Expiration Date 9/15/2026
Facility Type Physician Office
Lab Director DR. LISA R. BARKER

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