04D0869630 CLIA NUMBER - JEFFERSON COUNTY DIALYSIS INC

Laboratory Demographics

  • CLIA Code: 04D0869630
  • Facility Name: JEFFERSON COUNTY DIALYSIS INC
  • Facility Address: 2910 MARKET STREET
    PINE BLUFF, AR
    ZIP 71601
  • Facility Phone: 870 534-2233
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: JAMES A. CAMPBELL MD
  • NPI Number: 1154386597
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D0869630
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name JEFFERSON COUNTY DIALYSIS INC
Street 2910 MARKET STREET
City PINE BLUFF
State AR
ZIP 71601
Phone 870 534-2233
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 End Stage Renal Disease Dialysis Facility
Lab Director JAMES A. CAMPBELL MD

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