04D2081008 CLIA NUMBER - DANIEL BENNETT MD PA

Laboratory Demographics

  • CLIA Code: 04D2081008
  • Facility Name: DANIEL BENNETT MD PA
  • Facility Address: 1000 E MATTHEWS, STE B
    JONESBORO, AR
    ZIP 72401
  • Facility Phone: 870 932-6883
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. DANIEL B. BENNETT
  • NPI Number: 1447363833
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 04D2081008
LAB Type Physician Office
Facility Name DANIEL BENNETT MD PA
Street 1000 E MATTHEWS, STE B
City JONESBORO
State AR
ZIP 72401
Phone 870 932-6883
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/17/2024
Certificate Expiration Date 7/16/2026
Facility Type Physician Office
Lab Director DR. DANIEL B. BENNETT

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