04D2122991 CLIA NUMBER - ACCESS MEDICAL CLINIC DARDANELLE

Laboratory Demographics

  • CLIA Code: 04D2122991
  • Facility Name: ACCESS MEDICAL CLINIC DARDANELLE
  • Facility Address: 1176 STATE HWY 22 W, STE B
    DARDANELLE, AR
    ZIP 72834
  • Facility Phone: 479 229-3004
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: DR. MARK HAHN
  • NPI Number: 1568904480
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2122991
LAB Type Rural Health Clinic
Facility Name ACCESS MEDICAL CLINIC DARDANELLE
Street 1176 STATE HWY 22 W, STE B
City DARDANELLE
State AR
ZIP 72834
Phone 479 229-3004
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/12/2024
Certificate Expiration Date 12/11/2026
Facility Type Rural Health Clinic
Lab Director DR. MARK HAHN

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