04D2027363 CLIA NUMBER - HIGGINBOTHAM FAMILY CLINIC

Laboratory Demographics

  • CLIA Code: 04D2027363
  • Facility Name: HIGGINBOTHAM FAMILY CLINIC
  • Facility Address: 1580 TANNER STREET
    ROCKPORT, AR
    ZIP 72104
  • Facility Phone: 501 337-9994
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MICHAEL D. HIGGINBOTHAM
  • NPI Number: 1033129713
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 04D2027363
LAB Type Physician Office
Facility Name HIGGINBOTHAM FAMILY CLINIC
Street 1580 TANNER STREET
City ROCKPORT
State AR
ZIP 72104
Phone 501 337-9994
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/22/2025
Certificate Expiration Date 7/21/2027
Facility Type Physician Office
Lab Director DR. MICHAEL D. HIGGINBOTHAM

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