04D0701209 CLIA NUMBER - LEE COUNTY COOPERATIVE CLINIC

Laboratory Demographics

  • CLIA Code: 04D0701209
  • Facility Name: LEE COUNTY COOPERATIVE CLINIC
  • Facility Address: 530 WEST ATKINS BOULEVARD
    MARIANNA, AR
    ZIP 72360
  • Facility Phone: 870 295-5225
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: DR. HARRY MICHEL
  • NPI Number: 1356359442
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D0701209
LAB Type Rural Health Clinic
Facility Name LEE COUNTY COOPERATIVE CLINIC
Street 530 WEST ATKINS BOULEVARD
City MARIANNA
State AR
ZIP 72360
Phone 870 295-5225
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/28/2025
Certificate Expiration Date 8/27/2027
Facility Type Rural Health Clinic
Lab Director DR. HARRY MICHEL

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