04D2123125 CLIA NUMBER - ST BERNARDS PHYSICIAN CLINICS, INC

Laboratory Demographics

  • CLIA Code: 04D2123125
  • Facility Name: ST BERNARDS PHYSICIAN CLINICS, INC
  • Facility Address: 1300 INDUSTRIAL PARK DRIVE
    TRUMANN, AR
    ZIP 72472
  • Facility Phone: 870 418-1122
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. JOHN T. DOW
  • NPI Number: 1972054146
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 04D2123125
LAB Type Physician Office
Facility Name ST BERNARDS PHYSICIAN CLINICS, INC
Street 1300 INDUSTRIAL PARK DRIVE
City TRUMANN
State AR
ZIP 72472
Phone 870 418-1122
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 3/9/2024
Certificate Expiration Date 3/8/2026
Facility Type Physician Office
Lab Director DR. JOHN T. DOW

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