04D0921726 CLIA NUMBER - DRASCO MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 04D0921726
  • Facility Name: DRASCO MEDICAL CLINIC
  • Facility Address: 60 GREERS FERRY ROAD
    DRASCO, AR
    ZIP 72530
  • Facility Phone: 870 668-3200
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: MICAH MOODY
  • NPI Number: 1962482430
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D0921726
LAB Type Rural Health Clinic
Facility Name DRASCO MEDICAL CLINIC
Street 60 GREERS FERRY ROAD
City DRASCO
State AR
ZIP 72530
Phone 870 668-3200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/23/2025
Certificate Expiration Date 3/22/2027
Facility Type Rural Health Clinic
Lab Director MICAH MOODY

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