04D2075414 CLIA NUMBER - OSCEOLA DIALYSIS

Laboratory Demographics

  • CLIA Code: 04D2075414
  • Facility Name: OSCEOLA DIALYSIS
  • Facility Address: 1332 KEISLER AVE
    OSCEOLA, AR
    ZIP 72370
  • Facility Phone: 870 563-4901
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: MASHHUD M. MIRZA
  • NPI Number: 1174578595
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2075414
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name OSCEOLA DIALYSIS
Street 1332 KEISLER AVE
City OSCEOLA
State AR
ZIP 72370
Phone 870 563-4901
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/27/2024
Certificate Expiration Date 3/26/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director MASHHUD M. MIRZA

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