04D2049890 CLIA NUMBER - ARCARE - FAYETTEVILLE

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Laboratory Demographics

CLIA Number: 04D2049890

Facility Name: ARCARE - FAYETTEVILLE

Facility Address:
2894 MCKEE CIRCLE OFFICE 101
FAYETTEVILLE, AR
ZIP 72703
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Facility Phone Number: 479 571-2100

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1720642770

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	04D2049890
LAB Type	Federally Qualified Health Center
Facility Name	ARCARE - FAYETTEVILLE
Street	2894 MCKEE CIRCLE OFFICE 101
City	FAYETTEVILLE
State	AR
ZIP	72703
Phone	479 571-2100
CertificateType	4
CertificateEffectiveDate	11/15/2022
CertificateExpirationDate	11/14/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024