04D0974322 CLIA NUMBER - HARRIS FAMILY MEDICINE PLLC

Laboratory Demographics

  • CLIA Code: 04D0974322
  • Facility Name: HARRIS FAMILY MEDICINE PLLC
  • Facility Address: 630 WEST COURT STREET, SUITE B
    PARAGOULD, AR
    ZIP 72450
  • Facility Phone: 870 236-9611
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RYAN HARRIS
  • NPI Number: 1124098587
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 04D0974322
LAB Type Physician Office
Facility Name HARRIS FAMILY MEDICINE PLLC
Street 630 WEST COURT STREET, SUITE B
City PARAGOULD
State AR
ZIP 72450
Phone 870 236-9611
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/9/2024
Certificate Expiration Date 8/8/2026
Facility Type Physician Office
Lab Director RYAN HARRIS

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