04D2187506 CLIA NUMBER - ARCARE 33 BENTONVILLE MEDICAL

Laboratory Demographics

  • CLIA Code: 04D2187506
  • Facility Name: ARCARE 33 BENTONVILLE MEDICAL
  • Facility Address: 2805 MID CITIES DRIVE SUITE 1
    BENTONVILLE, AR
    ZIP 72712
  • Facility Phone: 870 919-6696
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: KRISTINE M. PRUITT
  • NPI Number: 1487280384
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2187506
LAB Type Federally Qualified Health Center
Facility Name ARCARE 33 BENTONVILLE MEDICAL
Street 2805 MID CITIES DRIVE SUITE 1
City BENTONVILLE
State AR
ZIP 72712
Phone 870 919-6696
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/2/2024
Certificate Expiration Date 7/1/2026
Facility Type Federally Qualified Health Center
Lab Director KRISTINE M. PRUITT

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