04D2115088 CLIA NUMBER - BAPTIST HEALTH FAMILY CLINIC - CONWAY

Laboratory Demographics

  • CLIA Code: 04D2115088
  • Facility Name: BAPTIST HEALTH FAMILY CLINIC - CONWAY
  • Facility Address: 625 UNITED DRIVE, SUITE 120
    CONWAY, AR
    ZIP 72032
  • Facility Phone: 501 358-6720
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WHITNEY P. EASON
  • NPI Number: 1083160899
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 04D2115088
LAB Type Physician Office
Facility Name BAPTIST HEALTH FAMILY CLINIC - CONWAY
Street 625 UNITED DRIVE, SUITE 120
City CONWAY
State AR
ZIP 72032
Phone 501 358-6720
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/1/2025
Certificate Expiration Date 6/30/2027
Facility Type Physician Office
Lab Director WHITNEY P. EASON

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