04D2157057 CLIA NUMBER - PRECISION SURGICAL CENTER OF NORTHWEST AR, LLC

Laboratory Demographics

CLIA Number: 04D2157057

Facility Name: PRECISION SURGICAL CENTER OF NORTHWEST AR, LLC

Facility Address:
3728 PINNACLE HILLS PARKWAY, SUITE 100
ROGERS, AR
ZIP 72758
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Facility Phone Number: 479 790-3328

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1194209437

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	04D2157057
LAB Type	Ambulatory Surgery Center
Facility Name	PRECISION SURGICAL CENTER OF NORTHWEST AR, LLC
Street	3728 PINNACLE HILLS PARKWAY, SUITE 100
City	ROGERS
State	AR
ZIP	72758
Phone	479 790-3328
CertificateType	4
CertificateEffectiveDate	10/30/2022
CertificateExpirationDate	10/29/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024