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04D2167830 CLIA NUMBER - JENNIFER BINGHAM MD PLLC

Laboratory Demographics

CLIA Number: 04D2167830

Facility Name: JENNIFER BINGHAM MD PLLC

Facility Address:
158 E SUNBRIDGE DR, STE 1
FAYETTEVILLE, AR
ZIP 72703
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Facility Phone Number: 479 287-4370

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1992165518

Taxonomy: 171M00000X - Case Manager/Care Coordinator
A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.

CLIA Record

Field Name Field Value
CLIA Number 04D2167830
LAB Type Physician Office
Facility Name JENNIFER BINGHAM MD PLLC
Street 158 E SUNBRIDGE DR, STE 1
City FAYETTEVILLE
State AR
ZIP 72703
Phone 479 287-4370
CertificateType 4
CertificateEffectiveDate 6/17/2023
CertificateExpirationDate 6/16/2025
FacilityType Waiver

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