04D2090660 CLIA NUMBER - BAPTIST HEALTH FAMILY CLINIC - PRESCOTT

Laboratory Demographics

  • CLIA Code: 04D2090660
  • Facility Name: BAPTIST HEALTH FAMILY CLINIC - PRESCOTT
  • Facility Address: 1484 WEST FIRST STREET NORTH
    PRESCOTT, AR
    ZIP 71857
  • Facility Phone: 870 887-0155
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: DR. NOLAND H. HAGOOD
  • NPI Number: 1518356112
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2090660
LAB Type Rural Health Clinic
Facility Name BAPTIST HEALTH FAMILY CLINIC - PRESCOTT
Street 1484 WEST FIRST STREET NORTH
City PRESCOTT
State AR
ZIP 71857
Phone 870 887-0155
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/28/2025
Certificate Expiration Date 1/27/2027
Facility Type Rural Health Clinic
Lab Director DR. NOLAND H. HAGOOD

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