04D1105415 CLIA NUMBER - JERRY L HARVEY DO PA

Laboratory Demographics

  • CLIA Code: 04D1105415
  • Facility Name: JERRY L HARVEY DO PA
  • Facility Address: 15361 HWY 5 SUITE E
    CABOT, AR
    ZIP 72023
  • Facility Phone: 501 605-9355
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JERRY L. HARVEY
  • NPI Number: 1487602470
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 04D1105415
LAB Type Physician Office
Facility Name JERRY L HARVEY DO PA
Street 15361 HWY 5 SUITE E
City CABOT
State AR
ZIP 72023
Phone 501 605-9355
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/23/2025
Certificate Expiration Date 9/22/2027
Facility Type Physician Office
Lab Director JERRY L. HARVEY

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