04D0913308 CLIA NUMBER - NORTHWEST FAMILY MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 04D0913308
  • Facility Name: NORTHWEST FAMILY MEDICAL CENTER
  • Facility Address: 2422 N THOMPSON STREET
    SPRINGDALE, AR
    ZIP 72764
  • Facility Phone: 479 750-6585
  • Facility Type: Other
  • Facility Type: Microscopy
  • Lab Director: RONALD BRIMBERRY
  • NPI Number: 1487624490
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 04D0913308
LAB Type Other
Facility Name NORTHWEST FAMILY MEDICAL CENTER
Street 2422 N THOMPSON STREET
City SPRINGDALE
State AR
ZIP 72764
Phone 479 750-6585
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 3/27/2024
Certificate Expiration Date 3/26/2026
Facility Type Other
Lab Director RONALD BRIMBERRY

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