04D0964179 CLIA NUMBER - PAUL W DAVIS, MD, PA

Laboratory Demographics

  • CLIA Code: 04D0964179
  • Facility Name: PAUL W DAVIS, MD, PA
  • Facility Address: 7400 DOLLARWAY ROAD STE A
    WHITE HALL, AR
    ZIP 71602
  • Facility Phone: 870 879-6791
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. PAUL W. DAVIS
  • NPI Number: 1386637221
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 04D0964179
LAB Type Physician Office
Facility Name PAUL W DAVIS, MD, PA
Street 7400 DOLLARWAY ROAD STE A
City WHITE HALL
State AR
ZIP 71602
Phone 870 879-6791
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 4/17/2025
Certificate Expiration Date 4/16/2027
Facility Type Physician Office
Lab Director DR. PAUL W. DAVIS

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