04D2019191 CLIA NUMBER - SHILOH CLINIC WASHINGTON REGIONAL

Laboratory Demographics

  • CLIA Code: 04D2019191
  • Facility Name: SHILOH CLINIC WASHINGTON REGIONAL
  • Facility Address: 513 N SHILOH ST
    SPRINGDALE, AR
    ZIP 72764
  • Facility Phone: 479 419-9902
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. WILLIAM C. KENDRICK
  • NPI Number: 1700188117
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 04D2019191
LAB Type Physician Office
Facility Name SHILOH CLINIC WASHINGTON REGIONAL
Street 513 N SHILOH ST
City SPRINGDALE
State AR
ZIP 72764
Phone 479 419-9902
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/25/2025
Certificate Expiration Date 1/24/2027
Facility Type Physician Office
Lab Director DR. WILLIAM C. KENDRICK

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