04D1021309 CLIA NUMBER - RENAL CARE OF MARION

Laboratory Demographics

  • CLIA Code: 04D1021309
  • Facility Name: RENAL CARE OF MARION
  • Facility Address: 1120 STATE HIGHWAY 77, STE 2
    MARION, AR
    ZIP 72364
  • Facility Phone: 870 735-4087
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: MASHHUD M. MIRZA
  • NPI Number: 1003861642
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D1021309
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name RENAL CARE OF MARION
Street 1120 STATE HIGHWAY 77, STE 2
City MARION
State AR
ZIP 72364
Phone 870 735-4087
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/20/2024
Certificate Expiration Date 1/19/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director MASHHUD M. MIRZA

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