04D1103881 CLIA NUMBER - QUEST DIAGNOSTICS LAKE VILLAGE

Laboratory Demographics

  • CLIA Code: 04D1103881
  • Facility Name: QUEST DIAGNOSTICS LAKE VILLAGE
  • Facility Address: 2918 LOUIS SESSIONS STREET, SUITE A
    LAKE VILLAGE, AR
    ZIP 71653
  • Facility Phone: 870 265-2164
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: CATITLIN HOFFMAN
  • NPI Number: 1013244417
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 04D1103881
LAB Type Independent
Facility Name QUEST DIAGNOSTICS LAKE VILLAGE
Street 2918 LOUIS SESSIONS STREET, SUITE A
City LAKE VILLAGE
State AR
ZIP 71653
Phone 870 265-2164
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/20/2025
Certificate Expiration Date 8/19/2027
Facility Type Independent
Lab Director CATITLIN HOFFMAN

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