04D0960047 CLIA NUMBER - PLEASANT VALLEY HEALTH AND REHAB LLC

Laboratory Demographics

  • CLIA Code: 04D0960047
  • Facility Name: PLEASANT VALLEY HEALTH AND REHAB LLC
  • Facility Address: 12111 HINSON ROAD
    LITTLE ROCK, AR
    ZIP 72212
  • Facility Phone: 318 443-8167
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DANA BURNETT
  • NPI Number: 1316442395
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 04D0960047
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PLEASANT VALLEY HEALTH AND REHAB LLC
Street 12111 HINSON ROAD
City LITTLE ROCK
State AR
ZIP 72212
Phone 318 443-8167
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/27/2025
Certificate Expiration Date 4/26/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DANA BURNETT

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