04D2105454 CLIA NUMBER - UNITY HEALTH BRADFORD MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 04D2105454
  • Facility Name: UNITY HEALTH BRADFORD MEDICAL CLINIC
  • Facility Address: 504 WEST MAIN STUITE A
    BRADFORD, AR
    ZIP 72020
  • Facility Phone: 501 203-2188
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. GLEN KNOWLES
  • NPI Number: 1386015097
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2105454
LAB Type Physician Office
Facility Name UNITY HEALTH BRADFORD MEDICAL CLINIC
Street 504 WEST MAIN STUITE A
City BRADFORD
State AR
ZIP 72020
Phone 501 203-2188
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/24/2023
Certificate Expiration Date 11/23/2025
Facility Type Physician Office
Lab Director DR. GLEN KNOWLES

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