04D0677764 CLIA NUMBER - PRESBYTERIAN VILLAGE HEALTH CARE CTR

Laboratory Demographics

  • CLIA Code: 04D0677764
  • Facility Name: PRESBYTERIAN VILLAGE HEALTH CARE CTR
  • Facility Address: 500 BROOKSIDE DRIVE
    LITTLE ROCK, AR
    ZIP 72205
  • Facility Phone: 501 225-1615
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: HAROLD H. HEDGES
  • NPI Number: 1457561656
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 04D0677764
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PRESBYTERIAN VILLAGE HEALTH CARE CTR
Street 500 BROOKSIDE DRIVE
City LITTLE ROCK
State AR
ZIP 72205
Phone 501 225-1615
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director HAROLD H. HEDGES

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