04D2108081 CLIA NUMBER - LIVING TREE PEDIATRICS, PLLC

Laboratory Demographics

  • CLIA Code: 04D2108081
  • Facility Name: LIVING TREE PEDIATRICS, PLLC
  • Facility Address: 1110 SE 30TH STREET
    BENTONVILLE, AR
    ZIP 72712
  • Facility Phone: 314 620-1719
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JEFFREY A. SAVAGE
  • NPI Number: 1396102679
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 04D2108081
LAB Type Physician Office
Facility Name LIVING TREE PEDIATRICS, PLLC
Street 1110 SE 30TH STREET
City BENTONVILLE
State AR
ZIP 72712
Phone 314 620-1719
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/28/2024
Certificate Expiration Date 1/27/2026
Facility Type Physician Office
Lab Director DR. JEFFREY A. SAVAGE

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