04D2045427 CLIA NUMBER - MAPLE CREEK MEDICAL CLINIC A MEMBER OF AR FAMILY CARE NETWORK, P.A.

Laboratory Demographics

  • CLIA Code: 04D2045427
  • Facility Name: MAPLE CREEK MEDICAL CLINIC A MEMBER OF AR FAMILY CARE NETWORK, P.A.
  • Facility Address: 21019 HWY 167, SUITE 200
    HENSLEY, AR
    ZIP 72065
  • Facility Phone: 501 224-1690
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. JOSHUA A. MOTES
  • NPI Number: 1184430134
  • Taxonomy: 101YP2500X - Counselor

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 04D2045427
LAB Type Physician Office
Facility Name MAPLE CREEK MEDICAL CLINIC A MEMBER OF AR FAMILY CARE NETWORK, P.A.
Street 21019 HWY 167, SUITE 200
City HENSLEY
State AR
ZIP 72065
Phone 501 224-1690
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/13/2024
Certificate Expiration Date 8/12/2026
Facility Type Physician Office
Lab Director DR. JOSHUA A. MOTES

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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