04D0895127 CLIA NUMBER - CRESTPARK FORREST CITY LLC

Laboratory Demographics

  • CLIA Code: 04D0895127
  • Facility Name: CRESTPARK FORREST CITY LLC
  • Facility Address: 500 KITTEL ROAD
    FORREST CITY, AR
    ZIP 72335
  • Facility Phone: 870 633-4260
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: LAUREL DAVIS
  • NPI Number: 1417102468
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 04D0895127
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name CRESTPARK FORREST CITY LLC
Street 500 KITTEL ROAD
City FORREST CITY
State AR
ZIP 72335
Phone 870 633-4260
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/30/2024
Certificate Expiration Date 11/29/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director LAUREL DAVIS

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