04D0697504 CLIA NUMBER - SPRINGHILL DIALYSIS

Laboratory Demographics

CLIA Number: 04D0697504

Facility Name: SPRINGHILL DIALYSIS

Facility Address:
3401 SPRINGHILL DR, SUITE 190
NORTH LITTLE ROCK, AR
ZIP 72117
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Facility Phone Number: 501 945-3669

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1568453314

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	04D0697504
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	SPRINGHILL DIALYSIS
Street	3401 SPRINGHILL DR, SUITE 190
City	NORTH LITTLE ROCK
State	AR
ZIP	72117
Phone	501 945-3669
CertificateType	4
CertificateEffectiveDate	7/17/2023
CertificateExpirationDate	7/16/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024