04D2096797 CLIA NUMBER - POCAHONTAS DIALYSIS

Laboratory Demographics

  • CLIA Code: 04D2096797
  • Facility Name: POCAHONTAS DIALYSIS
  • Facility Address: 404 CAMP RD
    POCAHONTAS, AR
    ZIP 72455
  • Facility Phone: 000 870-2480
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: CLINTON EDWARDS
  • NPI Number: 1780747352
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 04D2096797
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name POCAHONTAS DIALYSIS
Street 404 CAMP RD
City POCAHONTAS
State AR
ZIP 72455
Phone 000 870-2480
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/2/2025
Certificate Expiration Date 6/1/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director CLINTON EDWARDS

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