04D0466915 CLIA NUMBER - ST VINCENT HEALTH CLINIC EAST

Laboratory Demographics

  • CLIA Code: 04D0466915
  • Facility Name: ST VINCENT HEALTH CLINIC EAST
  • Facility Address: 2500 E 6TH STREET
    LITTLE ROCK, AR
    ZIP 72202
  • Facility Phone: 501 552-4710
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. DASS SANJAY
  • NPI Number: 1861786774
  • Taxonomy: 122300000X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 04D0466915
LAB Type Physician Office
Facility Name ST VINCENT HEALTH CLINIC EAST
Street 2500 E 6TH STREET
City LITTLE ROCK
State AR
ZIP 72202
Phone 501 552-4710
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/17/2024
Certificate Expiration Date 2/16/2026
Facility Type Physician Office
Lab Director DR. DASS SANJAY

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