04D2072962 CLIA NUMBER - ARCARE 42

Laboratory Demographics

  • CLIA Code: 04D2072962
  • Facility Name: ARCARE 42
  • Facility Address: 15 OLD SANDY ROAD
    MAYFLOWER, AR
    ZIP 72106
  • Facility Phone: 501 470-9780
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: DR. KRISTINE M. PRUITT
  • NPI Number: 1558782888
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2072962
LAB Type Federally Qualified Health Center
Facility Name ARCARE 42
Street 15 OLD SANDY ROAD
City MAYFLOWER
State AR
ZIP 72106
Phone 501 470-9780
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/10/2024
Certificate Expiration Date 2/9/2026
Facility Type Federally Qualified Health Center
Lab Director DR. KRISTINE M. PRUITT

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