04D2071136 CLIA NUMBER - MARION MINOR MEDICAL

Laboratory Demographics

  • CLIA Code: 04D2071136
  • Facility Name: MARION MINOR MEDICAL
  • Facility Address: 136 BLOCK ST
    MARION, AR
    ZIP 72364
  • Facility Phone: 870 559-2314
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MR. MICHEAL CHARLTON
  • NPI Number: 1962823310
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 04D2071136
LAB Type Physician Office
Facility Name MARION MINOR MEDICAL
Street 136 BLOCK ST
City MARION
State AR
ZIP 72364
Phone 870 559-2314
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/3/2024
Certificate Expiration Date 1/2/2026
Facility Type Physician Office
Lab Director MR. MICHEAL CHARLTON

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