04D2008363 CLIA NUMBER - MINIMAL ACCESS SURGERY CLINIC

Laboratory Demographics

  • CLIA Code: 04D2008363
  • Facility Name: MINIMAL ACCESS SURGERY CLINIC
  • Facility Address: 5230 WILLOW CREEK DR STE 201
    SPRINGDALE, AR
    ZIP 72762
  • Facility Phone: 479 927-3100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHN H. KENDRICK
  • NPI Number: 1427151497
  • Taxonomy: 208600000X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 04D2008363
LAB Type Physician Office
Facility Name MINIMAL ACCESS SURGERY CLINIC
Street 5230 WILLOW CREEK DR STE 201
City SPRINGDALE
State AR
ZIP 72762
Phone 479 927-3100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/9/2024
Certificate Expiration Date 6/8/2026
Facility Type Physician Office
Lab Director JOHN H. KENDRICK

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