04D0671487 CLIA NUMBER - SOUTHERN PINES HEALTH AND REHAB

Laboratory Demographics

  • CLIA Code: 04D0671487
  • Facility Name: SOUTHERN PINES HEALTH AND REHAB
  • Facility Address: 700 MANOR DRIVE
    PRESCOTT, AR
    ZIP 71857
  • Facility Phone: 870 455-1086
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MICHAEL G. MAGBY
  • NPI Number: 1215676903
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 04D0671487
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name SOUTHERN PINES HEALTH AND REHAB
Street 700 MANOR DRIVE
City PRESCOTT
State AR
ZIP 71857
Phone 870 455-1086
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/22/2023
Certificate Expiration Date 5/21/2025
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director MICHAEL G. MAGBY

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This page was last updated on: 3/20/2025