04D2041418 CLIA NUMBER - COSMETIC SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 04D2041418
  • Facility Name: COSMETIC SURGERY CENTER
  • Facility Address: 10809 EXECUTIVE CENTER DR STE 100 SEARCY BUILDING, 1ST FLOOR, SUTIE 100
    LITTLE ROCK, AR
    ZIP 72211
  • Facility Phone: 501 227-0707
  • Facility Type: Other - OFFICE BASED SURGERY CENT
  • Facility Type: Waiver
  • Lab Director: LESLIE H. SMITH
  • NPI Number: 1912108945
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 04D2041418
LAB Type Other - OFFICE BASED SURGERY CENT
Facility Name COSMETIC SURGERY CENTER
Street 10809 EXECUTIVE CENTER DR STE 100 SEARCY BUILDING, 1ST FLOOR, SUTIE 100
City LITTLE ROCK
State AR
ZIP 72211
Phone 501 227-0707
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/22/2024
Certificate Expiration Date 5/21/2026
Facility Type Other - OFFICE BASED SURGERY CENT
Lab Director LESLIE H. SMITH

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