04D0468423 CLIA NUMBER - AUTUMN HILL

Laboratory Demographics

  • CLIA Code: 04D0468423
  • Facility Name: AUTUMN HILL
  • Facility Address: 500 HAMMONDS AVENUE
    BERRYVILLE, AR
    ZIP 72616
  • Facility Phone: 870 423-6966
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JOSH KILGORE
  • NPI Number: 1811227432
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 04D0468423
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name AUTUMN HILL
Street 500 HAMMONDS AVENUE
City BERRYVILLE
State AR
ZIP 72616
Phone 870 423-6966
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/16/2025
Certificate Expiration Date 7/15/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director JOSH KILGORE

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