04D2021878 CLIA NUMBER - FIRST US CLINIC PA

Laboratory Demographics

  • CLIA Code: 04D2021878
  • Facility Name: FIRST US CLINIC PA
  • Facility Address: 1801 WEST 40TH AVE, SUITE 1C
    PINE BLUFF, AR
    ZIP 71603
  • Facility Phone: 870 535-4141
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. OLABODE J. OLUMOFIN
  • NPI Number: 1750513982
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 04D2021878
LAB Type Physician Office
Facility Name FIRST US CLINIC PA
Street 1801 WEST 40TH AVE, SUITE 1C
City PINE BLUFF
State AR
ZIP 71603
Phone 870 535-4141
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/16/2025
Certificate Expiration Date 6/15/2027
Facility Type Physician Office
Lab Director DR. OLABODE J. OLUMOFIN

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