04D2123684 CLIA NUMBER - SUGARLOAF MEDICAL CLINIC

Laboratory Demographics

CLIA Number: 04D2123684

Facility Name: SUGARLOAF MEDICAL CLINIC

Facility Address:
521 WILBURN ROAD
HEBER SPRINGS, AR
ZIP 72543
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Facility Phone Number: 501 270-4200

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1013451186

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	04D2123684
LAB Type	Community Clinic
Facility Name	SUGARLOAF MEDICAL CLINIC
Street	521 WILBURN ROAD
City	HEBER SPRINGS
State	AR
ZIP	72543
Phone	501 270-4200
CertificateType	4
CertificateEffectiveDate	12/28/2022
CertificateExpirationDate	12/27/2024
FacilityType	Waiver

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