04D1025987 CLIA NUMBER - OLSEN CLINIC MARK F OLSEN, MD

Laboratory Demographics

  • CLIA Code: 04D1025987
  • Facility Name: OLSEN CLINIC MARK F OLSEN, MD
  • Facility Address: 5501 WILLOW CREEK DR SUITE 104
    SPRINGDALE, AR
    ZIP 72762
  • Facility Phone: 479 770-4100
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MARK F. OLSEN
  • NPI Number: 1871896373
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D1025987
LAB Type Physician Office
Facility Name OLSEN CLINIC MARK F OLSEN, MD
Street 5501 WILLOW CREEK DR SUITE 104
City SPRINGDALE
State AR
ZIP 72762
Phone 479 770-4100
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 5/24/2024
Certificate Expiration Date 5/23/2026
Facility Type Physician Office
Lab Director MARK F. OLSEN

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