04D2123684 CLIA NUMBER - SUGARLOAF MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 04D2123684
  • Facility Name: SUGARLOAF MEDICAL CLINIC
  • Facility Address: 521 WILBURN ROAD
    HEBER SPRINGS, AR
    ZIP 72543
  • Facility Phone: 501 270-4200
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: SUZANNA BLACKBURN
  • NPI Number: 1013451186
  • Taxonomy: 261QR1300X - Clinic/Center

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/28/2024
Certificate Expiration Date 12/27/2026
Facility Type Community Clinic
Lab Director SUZANNA BLACKBURN

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