04D2050504 CLIA NUMBER - MERCY CLINIC CARDIOLOGY PHYSICIANS PLAZA

Laboratory Demographics

  • CLIA Code: 04D2050504
  • Facility Name: MERCY CLINIC CARDIOLOGY PHYSICIANS PLAZA
  • Facility Address: 2708 RIFE MEDICAL LANE, SUITE 220
    ROGERS, AR
    ZIP 72758
  • Facility Phone: 479 338-4432
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. LANCE FADDIS
  • NPI Number: 1538325931
  • Taxonomy: 207T00000X - Neurological Surgery

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CLIA Record

Field Name Field Value
CLIA Number 04D2050504
LAB Type Physician Office
Facility Name MERCY CLINIC CARDIOLOGY PHYSICIANS PLAZA
Street 2708 RIFE MEDICAL LANE, SUITE 220
City ROGERS
State AR
ZIP 72758
Phone 479 338-4432
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/30/2024
Certificate Expiration Date 11/29/2026
Facility Type Physician Office
Lab Director DR. LANCE FADDIS

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