04D2069010 CLIA NUMBER - DOCTOR'S HEALTH GROUP, INC DBA PARAGOULD DOCTOR'S CLINIC

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Laboratory Demographics

CLIA Number: 04D2069010

Facility Name: DOCTOR'S HEALTH GROUP, INC DBA PARAGOULD DOCTOR'S CLINIC

Facility Address:
4000 LINWOOD DRIVE, SUITE A
PARAGOULD, AR
ZIP 72450
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Facility Phone Number: 870 239-8503

Facility Type: Rural Health Clinic

Certificate Type: Microscopy

NPI Number: 1700849692

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	04D2069010
LAB Type	Rural Health Clinic
Facility Name	DOCTOR'S HEALTH GROUP, INC DBA PARAGOULD DOCTOR'S CLINIC
Street	4000 LINWOOD DRIVE, SUITE A
City	PARAGOULD
State	AR
ZIP	72450
Phone	870 239-8503
CertificateType	3
CertificateEffectiveDate	11/15/2023
CertificateExpirationDate	11/14/2025
FacilityType	PPMP

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