04D0967743 CLIA NUMBER - PINE BLUFF INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 04D0967743
  • Facility Name: PINE BLUFF INTERNAL MEDICINE
  • Facility Address: 1710 WEST 42ND AVE
    PINE BLUFF, AR
    ZIP 71603
  • Facility Phone: 870 535-4400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JAMES S. CASH
  • NPI Number: 1366483992
  • Taxonomy: 207ZP0102X - Pathology

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CLIA Record

Field Name Field Value
CLIA Number 04D0967743
LAB Type Physician Office
Facility Name PINE BLUFF INTERNAL MEDICINE
Street 1710 WEST 42ND AVE
City PINE BLUFF
State AR
ZIP 71603
Phone 870 535-4400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/22/2023
Certificate Expiration Date 11/21/2025
Facility Type Physician Office
Lab Director DR. JAMES S. CASH

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