04D2039973 CLIA NUMBER - ARCARE 29

Laboratory Demographics

  • CLIA Code: 04D2039973
  • Facility Name: ARCARE 29
  • Facility Address: 800 MAIN STREET
    AUGUSTA, AR
    ZIP 72006
  • Facility Phone: 870 347-3402
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: KRISTINE M. PRUITT
  • NPI Number: 1275635542
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2039973
LAB Type Federally Qualified Health Center
Facility Name ARCARE 29
Street 800 MAIN STREET
City AUGUSTA
State AR
ZIP 72006
Phone 870 347-3402
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2024
Certificate Expiration Date 4/19/2026
Facility Type Federally Qualified Health Center
Lab Director KRISTINE M. PRUITT

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