04D2161704 CLIA NUMBER - SPRINGDALE DIALYSIS CENTER

Laboratory Demographics

  • CLIA Code: 04D2161704
  • Facility Name: SPRINGDALE DIALYSIS CENTER
  • Facility Address: 2158 BUTTERFIELD COACH RD
    SPRINGDALE, AR
    ZIP 72764
  • Facility Phone: 479 463-7000
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: ROBERT S. BOMSTAD
  • NPI Number: 1205989746
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 04D2161704
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name SPRINGDALE DIALYSIS CENTER
Street 2158 BUTTERFIELD COACH RD
City SPRINGDALE
State AR
ZIP 72764
Phone 479 463-7000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/8/2025
Certificate Expiration Date 2/7/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director ROBERT S. BOMSTAD

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