04D2152463 CLIA NUMBER - HELENA MEDICAL CLINIC PHILLIPS CLINIC COMPANY, LLC

Laboratory Demographics

  • CLIA Code: 04D2152463
  • Facility Name: HELENA MEDICAL CLINIC PHILLIPS CLINIC COMPANY, LLC
  • Facility Address: 1803 MARTIN LUTHER KING JR DRIVE SUITE A
    HELENA, AR
    ZIP 72342
  • Facility Phone: 870 338-7441
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: DR. DAVID WEBBER
  • NPI Number: 1053192401
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2152463
LAB Type Ancillary Testing Site in Health Care Center
Facility Name HELENA MEDICAL CLINIC PHILLIPS CLINIC COMPANY, LLC
Street 1803 MARTIN LUTHER KING JR DRIVE SUITE A
City HELENA
State AR
ZIP 72342
Phone 870 338-7441
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/9/2024
Certificate Expiration Date 8/8/2026
Facility Type Ancillary Testing Site in Health Care Center
Lab Director DR. DAVID WEBBER

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