04D1057620 CLIA NUMBER - FAIR PARK SURGERY CENTER SEYMOUR OPERATIONS LLC

Laboratory Demographics

  • CLIA Code: 04D1057620
  • Facility Name: FAIR PARK SURGERY CENTER SEYMOUR OPERATIONS LLC
  • Facility Address: 200 NORTH VAN BUREN
    LITTLE ROCK, AR
    ZIP 72205
  • Facility Phone: 501 664-5354
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DAVID R. ROZAS
  • NPI Number: 1730292418
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D1057620
LAB Type Ambulatory Surgery Center
Facility Name FAIR PARK SURGERY CENTER SEYMOUR OPERATIONS LLC
Street 200 NORTH VAN BUREN
City LITTLE ROCK
State AR
ZIP 72205
Phone 501 664-5354
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/17/2024
Certificate Expiration Date 8/16/2026
Facility Type Ambulatory Surgery Center
Lab Director DAVID R. ROZAS

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