04D0467975 CLIA NUMBER - JONESBORO INTERNAL MEDICINE CLINIC

Laboratory Demographics

  • CLIA Code: 04D0467975
  • Facility Name: JONESBORO INTERNAL MEDICINE CLINIC
  • Facility Address: 3202 METHODIST DRIVE
    JONESBORO, AR
    ZIP 72401
  • Facility Phone: 870 932-2221
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANNY E. GRUBBS MD
  • NPI Number: 1285739292
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 04D0467975
LAB Type Physician Office
Facility Name JONESBORO INTERNAL MEDICINE CLINIC
Street 3202 METHODIST DRIVE
City JONESBORO
State AR
ZIP 72401
Phone 870 932-2221
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/19/2023
Certificate Expiration Date 11/18/2025
Facility Type Physician Office
Lab Director DANNY E. GRUBBS MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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