04D1062382 CLIA NUMBER - ST VINCENT FAMILY CLINIC CHENAL

Laboratory Demographics

  • CLIA Code: 04D1062382
  • Facility Name: ST VINCENT FAMILY CLINIC CHENAL
  • Facility Address: 16221 ST VINCENT WAY, STE 100
    LITTLE ROCK, AR
    ZIP 72223
  • Facility Phone: 501 552-8150
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: GIL C. FOSTER
  • NPI Number: 1902157951
  • Taxonomy: 225100000X - Physical Therapist

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CLIA Record

Field Name Field Value
CLIA Number 04D1062382
LAB Type Physician Office
Facility Name ST VINCENT FAMILY CLINIC CHENAL
Street 16221 ST VINCENT WAY, STE 100
City LITTLE ROCK
State AR
ZIP 72223
Phone 501 552-8150
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 9/18/2024
Certificate Expiration Date 9/17/2026
Facility Type Physician Office
Lab Director GIL C. FOSTER

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