04D0881269 CLIA NUMBER - PROMED AMBULANCE, INC

Laboratory Demographics

  • CLIA Code: 04D0881269
  • Facility Name: PROMED AMBULANCE, INC
  • Facility Address: 1152 STRONG HWY
    EL DORADO, AR
    ZIP 71730
  • Facility Phone: 870 875-2273
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: KEN KELLEY
  • NPI Number: 1417057480
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 04D0881269
LAB Type Ambulance
Facility Name PROMED AMBULANCE, INC
Street 1152 STRONG HWY
City EL DORADO
State AR
ZIP 71730
Phone 870 875-2273
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/6/2024
Certificate Expiration Date 1/5/2026
Facility Type Ambulance
Lab Director KEN KELLEY

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