04D0932085 CLIA NUMBER - CHILD & ADOLESCENT MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 04D0932085
  • Facility Name: CHILD & ADOLESCENT MEDICAL CLINIC
  • Facility Address: 1204 WEST KINGSHIGHWAY
    PARAGOULD, AR
    ZIP 72450
  • Facility Phone: 870 239-5437
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JANET C. CRAWFORD
  • NPI Number: 1831257070
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 04D0932085
LAB Type Physician Office
Facility Name CHILD & ADOLESCENT MEDICAL CLINIC
Street 1204 WEST KINGSHIGHWAY
City PARAGOULD
State AR
ZIP 72450
Phone 870 239-5437
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 8/12/2025
Certificate Expiration Date 8/11/2027
Facility Type Physician Office
Lab Director JANET C. CRAWFORD

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