04D2049073 CLIA NUMBER - CONSTANCE H SMITH MD PA

Laboratory Demographics

  • CLIA Code: 04D2049073
  • Facility Name: CONSTANCE H SMITH MD PA
  • Facility Address: 533 N 10TH ST
    BLYTHEVILLE, AR
    ZIP 72315
  • Facility Phone: 870 762-1942
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. CONSTANCE H. SMITH
  • NPI Number: 1508242744
  • Taxonomy: 171M00000X - Case Manager/Care Coordinator

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CLIA Record

Field Name Field Value
CLIA Number 04D2049073
LAB Type Physician Office
Facility Name CONSTANCE H SMITH MD PA
Street 533 N 10TH ST
City BLYTHEVILLE
State AR
ZIP 72315
Phone 870 762-1942
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/30/2024
Certificate Expiration Date 10/29/2026
Facility Type Physician Office
Lab Director DR. CONSTANCE H. SMITH

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