04D2145768 CLIA NUMBER - ARCARE 120

Laboratory Demographics

  • CLIA Code: 04D2145768
  • Facility Name: ARCARE 120
  • Facility Address: 908 EDMONDS AVENUE
    MCCRORY, AR
    ZIP 72101
  • Facility Phone: 870 731-1100
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: DR. KRISTINE M. PRUITT
  • NPI Number: 1720587306
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2145768
LAB Type Federally Qualified Health Center
Facility Name ARCARE 120
Street 908 EDMONDS AVENUE
City MCCRORY
State AR
ZIP 72101
Phone 870 731-1100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2024
Certificate Expiration Date 3/14/2026
Facility Type Federally Qualified Health Center
Lab Director DR. KRISTINE M. PRUITT

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