04D1030224 CLIA NUMBER - HARRISON SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 04D1030224
  • Facility Name: HARRISON SURGERY CENTER
  • Facility Address: 105 SAWGRASS PT
    HARRISON, AR
    ZIP 72601
  • Facility Phone: 870 741-9700
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: KENNETH M. KILGORE
  • NPI Number: 1063415891
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D1030224
LAB Type Ambulatory Surgery Center
Facility Name HARRISON SURGERY CENTER
Street 105 SAWGRASS PT
City HARRISON
State AR
ZIP 72601
Phone 870 741-9700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Ambulatory Surgery Center
Lab Director KENNETH M. KILGORE

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