04D0468723 CLIA NUMBER - OCH DECATUR CLINIC

Laboratory Demographics

  • CLIA Code: 04D0468723
  • Facility Name: OCH DECATUR CLINIC
  • Facility Address: 346 NORTH MAIN ST
    DECATUR, AR
    ZIP 72722
  • Facility Phone: 479 752-3233
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KENNETH J. SAMPLE
  • NPI Number: 1023028016
  • Taxonomy: 261QR1300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 04D0468723
LAB Type Physician Office
Facility Name OCH DECATUR CLINIC
Street 346 NORTH MAIN ST
City DECATUR
State AR
ZIP 72722
Phone 479 752-3233
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/28/2024
Certificate Expiration Date 9/27/2026
Facility Type Physician Office
Lab Director KENNETH J. SAMPLE

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