04D2072194 CLIA NUMBER - ST BERNARD'S LABORATORY - MANILA

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Laboratory Demographics

CLIA Number: 04D2072194

Facility Name: ST BERNARD'S LABORATORY - MANILA

Facility Address:
3644 WEST STATE HWY 18
MANILA, AR
ZIP 72442
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Facility Phone Number: 870 570-0193

Facility Type: Other - REFERENCE LAB

Certificate Type: Accreditation

NPI Number: 1275204307

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	04D2072194
LAB Type	Other - REFERENCE LAB
Facility Name	ST BERNARD'S LABORATORY - MANILA
Street	3644 WEST STATE HWY 18
City	MANILA
State	AR
ZIP	72442
Phone	870 570-0193
CertificateType	1
CertificateEffectiveDate	3/4/2023
CertificateExpirationDate	3/3/2025
FacilityType	Accreditation

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