04D1057548 CLIA NUMBER - CARE IV HOME HEALTH

Laboratory Demographics

  • CLIA Code: 04D1057548
  • Facility Name: CARE IV HOME HEALTH
  • Facility Address: 1310 WEST MAIN STREET
    RUSSELLVILLE, AR
    ZIP 72801
  • Facility Phone: 479 964-0072
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: RACHEL TUCKER
  • NPI Number: 1235149212
  • Taxonomy: 251E00000X - Home Health

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 04D1057548
LAB Type Home Health Agency
Facility Name CARE IV HOME HEALTH
Street 1310 WEST MAIN STREET
City RUSSELLVILLE
State AR
ZIP 72801
Phone 479 964-0072
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/15/2024
Certificate Expiration Date 8/14/2026
Facility Type Home Health Agency
Lab Director RACHEL TUCKER

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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