04D0896876 CLIA NUMBER - PLEASANT PLAINS MEDICAL CLINIC

Laboratory Demographics

CLIA Number: 04D0896876

Facility Name: PLEASANT PLAINS MEDICAL CLINIC

Facility Address:
6200 BATESVILLE BLVD
PLEASANT PLAINS, AR
ZIP 72568
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Facility Phone Number: 501 345-2182

Facility Type: Rural Health Clinic

Certificate Type: Microscopy

NPI Number: 1760452643

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	04D0896876
LAB Type	Rural Health Clinic
Facility Name	PLEASANT PLAINS MEDICAL CLINIC
Street	6200 BATESVILLE BLVD
City	PLEASANT PLAINS
State	AR
ZIP	72568
Phone	501 345-2182
CertificateType	3
CertificateEffectiveDate	4/14/2024
CertificateExpirationDate	4/13/2026
FacilityType	PPMP

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This page was last updated on: 4/23/2024