04D0962206 CLIA NUMBER - SALINE COUNTY DIALYSIS

Laboratory Demographics

  • CLIA Code: 04D0962206
  • Facility Name: SALINE COUNTY DIALYSIS
  • Facility Address: 1200 N MAIN, SUITE 2
    BENTON, AR
    ZIP 72015
  • Facility Phone: 501 776-1816
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. ALEX DAVID
  • NPI Number: 1164437646
  • Taxonomy: 261QP2000X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 04D0962206
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name SALINE COUNTY DIALYSIS
Street 1200 N MAIN, SUITE 2
City BENTON
State AR
ZIP 72015
Phone 501 776-1816
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/25/2025
Certificate Expiration Date 6/24/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. ALEX DAVID

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: 9/29/2025