04D2062899 CLIA NUMBER - EAR, NOSE & THROAT CENTER OF THE OZARKS

Laboratory Demographics

  • CLIA Code: 04D2062899
  • Facility Name: EAR, NOSE & THROAT CENTER OF THE OZARKS
  • Facility Address: 6823 ISAAC'S ORCHARD RD
    SPRINGDALE, AR
    ZIP 72762
  • Facility Phone: 479 750-2080
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LANCE MANNING
  • NPI Number: 1053492504
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 04D2062899
LAB Type Physician Office
Facility Name EAR, NOSE & THROAT CENTER OF THE OZARKS
Street 6823 ISAAC'S ORCHARD RD
City SPRINGDALE
State AR
ZIP 72762
Phone 479 750-2080
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/23/2025
Certificate Expiration Date 7/22/2027
Facility Type Physician Office
Lab Director LANCE MANNING

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