04D2028584 CLIA NUMBER - ARKANSAS DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 04D2028584
  • Facility Name: ARKANSAS DERMATOLOGY
  • Facility Address: 4261 STOCKTON DRIVE, SUITE 200
    NORTH LITTLE ROCK, AR
    ZIP 72117
  • Facility Phone: 501 791-7546
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: RANDALL L. BREAU
  • NPI Number: 1013930320
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 04D2028584
LAB Type Physician Office
Facility Name ARKANSAS DERMATOLOGY
Street 4261 STOCKTON DRIVE, SUITE 200
City NORTH LITTLE ROCK
State AR
ZIP 72117
Phone 501 791-7546
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 7/12/2024
Certificate Expiration Date 7/11/2026
Facility Type Physician Office
Lab Director RANDALL L. BREAU

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