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04D2188062 CLIA NUMBER - NORTH ARKANSAS REGENERATIVE MEDICINE LTD

Laboratory Demographics

CLIA Number: 04D2188062

Facility Name: NORTH ARKANSAS REGENERATIVE MEDICINE LTD

Facility Address:
5102 PAULINE WHITAKER PKWY SUITE 124
ROGERS, AR
ZIP 72758
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Facility Phone Number: 479 751-0190

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1356981641

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name Field Value
CLIA Number 04D2188062
LAB Type Physician Office
Facility Name NORTH ARKANSAS REGENERATIVE MEDICINE LTD
Street 5102 PAULINE WHITAKER PKWY SUITE 124
City ROGERS
State AR
ZIP 72758
Phone 479 751-0190
CertificateType 4
CertificateEffectiveDate 7/13/2022
CertificateExpirationDate 7/12/2024
FacilityType Waiver

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