04D1030816 CLIA NUMBER - BAXTER REGIONAL CARDIOVASCULAR CLINIC

Laboratory Demographics

  • CLIA Code: 04D1030816
  • Facility Name: BAXTER REGIONAL CARDIOVASCULAR CLINIC
  • Facility Address: 555 WEST 6TH STREET
    MOUNTAIN HOME, AR
    ZIP 72653
  • Facility Phone: 870 425-8288
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER S. WEBB
  • NPI Number: 1265197651
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 04D1030816
LAB Type Physician Office
Facility Name BAXTER REGIONAL CARDIOVASCULAR CLINIC
Street 555 WEST 6TH STREET
City MOUNTAIN HOME
State AR
ZIP 72653
Phone 870 425-8288
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/17/2024
Certificate Expiration Date 9/16/2026
Facility Type Physician Office
Lab Director CHRISTOPHER S. WEBB

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