04D1098522 CLIA NUMBER - SHERIDAN EYECARE CLINIC

Laboratory Demographics

  • CLIA Code: 04D1098522
  • Facility Name: SHERIDAN EYECARE CLINIC
  • Facility Address: 215 WEST HOLLY
    SHERIDAN, AR
    ZIP 72150
  • Facility Phone: 870 942-3621
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. TASKER N. RODMAN
  • NPI Number: 1679653885
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 04D1098522
LAB Type Physician Office
Facility Name SHERIDAN EYECARE CLINIC
Street 215 WEST HOLLY
City SHERIDAN
State AR
ZIP 72150
Phone 870 942-3621
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/21/2025
Certificate Expiration Date 4/20/2027
Facility Type Physician Office
Lab Director DR. TASKER N. RODMAN

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