04D2049895 CLIA NUMBER - ARCARE 69

Laboratory Demographics

  • CLIA Code: 04D2049895
  • Facility Name: ARCARE 69
  • Facility Address: 318 SOUTH RHODES STREET
    WEST MEMPHIS, AR
    ZIP 72301
  • Facility Phone: 870 394-3023
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: MS. KRISTINE M. PRUITT
  • NPI Number: 1215523931
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2049895
LAB Type Federally Qualified Health Center
Facility Name ARCARE 69
Street 318 SOUTH RHODES STREET
City WEST MEMPHIS
State AR
ZIP 72301
Phone 870 394-3023
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2024
Certificate Expiration Date 11/14/2026
Facility Type Federally Qualified Health Center
Lab Director MS. KRISTINE M. PRUITT

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