04D0919707 CLIA NUMBER - CONWAY ENDOSCOPY CENTER, INC

Laboratory Demographics

  • CLIA Code: 04D0919707
  • Facility Name: CONWAY ENDOSCOPY CENTER, INC
  • Facility Address: 455 HOGAN LANE
    CONWAY, AR
    ZIP 72034
  • Facility Phone: 501 513-0799
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. DAVID BACKSTEDT
  • NPI Number: 1265439632
  • Taxonomy: 261QE0800X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 04D0919707
LAB Type Physician Office
Facility Name CONWAY ENDOSCOPY CENTER, INC
Street 455 HOGAN LANE
City CONWAY
State AR
ZIP 72034
Phone 501 513-0799
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/13/2024
Certificate Expiration Date 9/12/2026
Facility Type Physician Office
Lab Director DR. DAVID BACKSTEDT

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: 6/4/2025