04D2011169 CLIA NUMBER - PHYSICIAN GROUP OF ARKANSAS, INC

Laboratory Demographics

  • CLIA Code: 04D2011169
  • Facility Name: PHYSICIAN GROUP OF ARKANSAS, INC
  • Facility Address: 302 BILL CLINTON DRIVE STE A
    HOPE, AR
    ZIP 71801
  • Facility Phone: 870 777-4868
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GEORGE C. GARRETT JR
  • NPI Number: 1093060824
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 04D2011169
LAB Type Physician Office
Facility Name PHYSICIAN GROUP OF ARKANSAS, INC
Street 302 BILL CLINTON DRIVE STE A
City HOPE
State AR
ZIP 71801
Phone 870 777-4868
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/12/2024
Certificate Expiration Date 8/11/2026
Facility Type Physician Office
Lab Director GEORGE C. GARRETT JR

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This page was last updated on: 3/20/2025