04D1038315 CLIA NUMBER - RIVER VALLEY PRIMARY CARE SERVICES

Laboratory Demographics

  • CLIA Code: 04D1038315
  • Facility Name: RIVER VALLEY PRIMARY CARE SERVICES
  • Facility Address: 9755 WEST STATE HIGHWAY 22
    RATCLIFF, AR
    ZIP 72951
  • Facility Phone: 479 431-2050
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: DR. PEGGY ROSSON
  • NPI Number: 1699010991
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D1038315
LAB Type Federally Qualified Health Center
Facility Name RIVER VALLEY PRIMARY CARE SERVICES
Street 9755 WEST STATE HIGHWAY 22
City RATCLIFF
State AR
ZIP 72951
Phone 479 431-2050
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 6/9/2024
Certificate Expiration Date 6/8/2026
Facility Type Federally Qualified Health Center
Lab Director DR. PEGGY ROSSON

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