04D1068056 CLIA NUMBER - POINTER TRAIL FAMILY CLINIC

Laboratory Demographics

  • CLIA Code: 04D1068056
  • Facility Name: POINTER TRAIL FAMILY CLINIC
  • Facility Address: 109 WEST POINTER TRAIL
    VAN BUREN, AR
    ZIP 72956
  • Facility Phone: 479 922-2222
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. CAROLYN M. DILLARD
  • NPI Number: 1578684148
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 04D1068056
LAB Type Physician Office
Facility Name POINTER TRAIL FAMILY CLINIC
Street 109 WEST POINTER TRAIL
City VAN BUREN
State AR
ZIP 72956
Phone 479 922-2222
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/1/2024
Certificate Expiration Date 2/28/2026
Facility Type Physician Office
Lab Director DR. CAROLYN M. DILLARD

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