04D2129005 CLIA NUMBER - ARCARE 87

Laboratory Demographics

  • CLIA Code: 04D2129005
  • Facility Name: ARCARE 87
  • Facility Address: 1127 MAIN STREET
    VILONIA, AR
    ZIP 72173
  • Facility Phone: 501 796-6740
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: MS. KRISTINE M. PRUITT
  • NPI Number: 1902356116
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2129005
LAB Type Federally Qualified Health Center
Facility Name ARCARE 87
Street 1127 MAIN STREET
City VILONIA
State AR
ZIP 72173
Phone 501 796-6740
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/11/2025
Certificate Expiration Date 4/10/2027
Facility Type Federally Qualified Health Center
Lab Director MS. KRISTINE M. PRUITT

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