04D0717370 CLIA NUMBER - FAMILY PRACTICE CENTER

Laboratory Demographics

  • CLIA Code: 04D0717370
  • Facility Name: FAMILY PRACTICE CENTER
  • Facility Address: 194 SHAKERAG ROAD
    CLINTON, AR
    ZIP 72031
  • Facility Phone: 501 745-2800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JOSE E. ABISEID
  • NPI Number: 1013108240
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D0717370
LAB Type Physician Office
Facility Name FAMILY PRACTICE CENTER
Street 194 SHAKERAG ROAD
City CLINTON
State AR
ZIP 72031
Phone 501 745-2800
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 Physician Office
Lab Director DR. JOSE E. ABISEID

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