04D2127171 CLIA NUMBER - ARKANSAS STATE VETERANS HOME

Laboratory Demographics

  • CLIA Code: 04D2127171
  • Facility Name: ARKANSAS STATE VETERANS HOME
  • Facility Address: 2401 JOHN ASHLEY DRIVE
    NLR, AR
    ZIP 72114
  • Facility Phone: 501 683-2382
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MS. JOHNSON DONALD
  • NPI Number: 1417113481
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 04D2127171
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name ARKANSAS STATE VETERANS HOME
Street 2401 JOHN ASHLEY DRIVE
City NLR
State AR
ZIP 72114
Phone 501 683-2382
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/10/2025
Certificate Expiration Date 3/9/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director MS. JOHNSON DONALD

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