04D0703375 CLIA NUMBER - MAINLINE HEALTH SYSTEMS DERMOTT

Laboratory Demographics

  • CLIA Code: 04D0703375
  • Facility Name: MAINLINE HEALTH SYSTEMS DERMOTT
  • Facility Address: 300 SOUTH SCHOOL STREET
    DERMOTT, AR
    ZIP 71638
  • Facility Phone: 870 358-3355
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: DR. JAMIE S. EVANS
  • NPI Number: 1669401501
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D0703375
LAB Type Physician Office
Facility Name MAINLINE HEALTH SYSTEMS DERMOTT
Street 300 SOUTH SCHOOL STREET
City DERMOTT
State AR
ZIP 71638
Phone 870 358-3355
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 6/3/2024
Certificate Expiration Date 6/2/2026
Facility Type Physician Office
Lab Director DR. JAMIE S. EVANS

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