04D2178700 CLIA NUMBER - LITTLE CREEK BEHAVIORAL HEALTH

Laboratory Demographics

  • CLIA Code: 04D2178700
  • Facility Name: LITTLE CREEK BEHAVIORAL HEALTH
  • Facility Address: 161 SKUNK HOLLOW RD
    CONWAY, AR
    ZIP 72032
  • Facility Phone: 870 352-8203
  • Facility Type: Other - BEHAVIORAL HEALTH
  • Facility Type: Waiver
  • Lab Director: NEDRA ALLEN-JONES
  • NPI Number: 1952482036
  • Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility

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CLIA Record

Field Name Field Value
CLIA Number 04D2178700
LAB Type Other - BEHAVIORAL HEALTH
Facility Name LITTLE CREEK BEHAVIORAL HEALTH
Street 161 SKUNK HOLLOW RD
City CONWAY
State AR
ZIP 72032
Phone 870 352-8203
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/7/2024
Certificate Expiration Date 2/6/2026
Facility Type Other - BEHAVIORAL HEALTH
Lab Director NEDRA ALLEN-JONES

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