04D2123597 CLIA NUMBER - HIDDEN SPRINGS DIALYSIS CENTER

Laboratory Demographics

CLIA Number: 04D2123597

Facility Name: HIDDEN SPRINGS DIALYSIS CENTER

Facility Address:
3000 NW A STREET
BENTONVILLE, AR
ZIP 72712
Get Directions

Facility Phone Number: 479 463-7000

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1104369297

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	04D2123597
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	HIDDEN SPRINGS DIALYSIS CENTER
Street	3000 NW A STREET
City	BENTONVILLE
State	AR
ZIP	72712
Phone	479 463-7000
CertificateType	4
CertificateEffectiveDate	12/27/2022
CertificateExpirationDate	12/26/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 4/23/2024