04D1037794 CLIA NUMBER - PREMIER CENTRAL DR SANDRA A K SOOMAN

Laboratory Demographics

  • CLIA Code: 04D1037794
  • Facility Name: PREMIER CENTRAL DR SANDRA A K SOOMAN
  • Facility Address: 900 SOUTH MAIN ST
    HOPE, AR
    ZIP 71801
  • Facility Phone: 870 722-6567
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SANDRA K. SOOMAN MD
  • NPI Number: 1265477582
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 04D1037794
LAB Type Physician Office
Facility Name PREMIER CENTRAL DR SANDRA A K SOOMAN
Street 900 SOUTH MAIN ST
City HOPE
State AR
ZIP 71801
Phone 870 722-6567
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/4/2025
Certificate Expiration Date 3/3/2027
Facility Type Physician Office
Lab Director SANDRA K. SOOMAN MD

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