04D2147100 CLIA NUMBER - ST BERNARDS INTERNAL MEDICINE RESIDENCY CLINIC

Laboratory Demographics

  • CLIA Code: 04D2147100
  • Facility Name: ST BERNARDS INTERNAL MEDICINE RESIDENCY CLINIC
  • Facility Address: 300 CARSON ST, SUITE A
    JONESBORO, AR
    ZIP 72401
  • Facility Phone: 870 910-7799
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: DR. ELIZABETH W. SALES
  • NPI Number: 1245771831
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 04D2147100
LAB Type Ancillary Testing Site in Health Care Center
Facility Name ST BERNARDS INTERNAL MEDICINE RESIDENCY CLINIC
Street 300 CARSON ST, SUITE A
City JONESBORO
State AR
ZIP 72401
Phone 870 910-7799
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/12/2024
Certificate Expiration Date 4/11/2026
Facility Type Ancillary Testing Site in Health Care Center
Lab Director DR. ELIZABETH W. SALES

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