04D0673171 CLIA NUMBER - MIDWAY MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 04D0673171
  • Facility Name: MIDWAY MEDICAL CLINIC
  • Facility Address: 195 HOSPITAL DRIVE, SUITE B
    CHEROKEE VILLAGE, AR
    ZIP 72529
  • Facility Phone: 870 257-6000
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: DR. LAUREN BLOCH
  • NPI Number: 1568432144
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D0673171
LAB Type Rural Health Clinic
Facility Name MIDWAY MEDICAL CLINIC
Street 195 HOSPITAL DRIVE, SUITE B
City CHEROKEE VILLAGE
State AR
ZIP 72529
Phone 870 257-6000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/17/2024
Certificate Expiration Date 5/16/2026
Facility Type Rural Health Clinic
Lab Director DR. LAUREN BLOCH

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