04D2173434 CLIA NUMBER - JONESBORO AMBULATORY SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 04D2173434
  • Facility Name: JONESBORO AMBULATORY SURGERY CENTER
  • Facility Address: 1710 MAYFIELD DR
    JONESBORO, AR
    ZIP 72401
  • Facility Phone: 504 554-1273
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MS. BETH L. WADDELL
  • NPI Number: 1811368327
  • Taxonomy: 367500000X - Nurse Anesthetist, Certified Registered

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CLIA Record

Field Name Field Value
CLIA Number 04D2173434
LAB Type Ambulatory Surgery Center
Facility Name JONESBORO AMBULATORY SURGERY CENTER
Street 1710 MAYFIELD DR
City JONESBORO
State AR
ZIP 72401
Phone 504 554-1273
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/14/2025
Certificate Expiration Date 10/13/2027
Facility Type Ambulatory Surgery Center
Lab Director MS. BETH L. WADDELL

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