04D1096838 CLIA NUMBER - FORREST CITY DIALYSIS

Laboratory Demographics

  • CLIA Code: 04D1096838
  • Facility Name: FORREST CITY DIALYSIS
  • Facility Address: 1501 NORTH WASHINGTON STREET
    FORREST CITY, AR
    ZIP 72335
  • Facility Phone: 870 494-4022
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: ASIF KAZMI
  • NPI Number: 1457599722
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D1096838
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name FORREST CITY DIALYSIS
Street 1501 NORTH WASHINGTON STREET
City FORREST CITY
State AR
ZIP 72335
Phone 870 494-4022
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/12/2025
Certificate Expiration Date 3/11/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director ASIF KAZMI

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