04D1087979 CLIA NUMBER - DIALYSIS CLINIC, INC-MCCRORY

Laboratory Demographics

  • CLIA Code: 04D1087979
  • Facility Name: DIALYSIS CLINIC, INC-MCCRORY
  • Facility Address: 139 W HWY 64, SUITE 100
    MCCRORY, AR
    ZIP 72101
  • Facility Phone: 870 731-2543
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. JAMES MAXWELL
  • NPI Number: 1881854396
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D1087979
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name DIALYSIS CLINIC, INC-MCCRORY
Street 139 W HWY 64, SUITE 100
City MCCRORY
State AR
ZIP 72101
Phone 870 731-2543
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/14/2024
Certificate Expiration Date 8/13/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. JAMES MAXWELL

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