04D0877362 CLIA NUMBER - CARE MANOR NURSING AND REHAB

Laboratory Demographics

  • CLIA Code: 04D0877362
  • Facility Name: CARE MANOR NURSING AND REHAB
  • Facility Address: 804 BURNETT DRIVE
    MOUNTAIN HOME, AR
    ZIP 72653
  • Facility Phone: 870 424-5030
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: RANDY SUTTERFIELD
  • NPI Number: 1609864537
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 04D0877362
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name CARE MANOR NURSING AND REHAB
Street 804 BURNETT DRIVE
City MOUNTAIN HOME
State AR
ZIP 72653
Phone 870 424-5030
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/2/2025
Certificate Expiration Date 10/1/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director RANDY SUTTERFIELD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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