04D0960238 CLIA NUMBER - FATHER BOB ALLEN CHARITABLE CLINIC

Laboratory Demographics

  • CLIA Code: 04D0960238
  • Facility Name: FATHER BOB ALLEN CHARITABLE CLINIC
  • Facility Address: 815 THHOMPSON AVE
    EL DORADO, AR
    ZIP 71730
  • Facility Phone: 870 864-8010
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: MS. JILL TEMPLE
  • NPI Number: 1568873586
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D0960238
LAB Type Community Clinic
Facility Name FATHER BOB ALLEN CHARITABLE CLINIC
Street 815 THHOMPSON AVE
City EL DORADO
State AR
ZIP 71730
Phone 870 864-8010
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2025
Certificate Expiration Date 5/3/2027
Facility Type Community Clinic
Lab Director MS. JILL TEMPLE

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