04D2188464 CLIA NUMBER - MAINLINE HEALTH SYSTEMS-UAM

Laboratory Demographics

  • CLIA Code: 04D2188464
  • Facility Name: MAINLINE HEALTH SYSTEMS-UAM
  • Facility Address: 136 UNIVERSITY COURT MAXWELL HALL
    MONTICELLO, AR
    ZIP 71655
  • Facility Phone: 870 367-6246
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: DR. JAMIE EVANS
  • NPI Number: 1205163540
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2188464
LAB Type Federally Qualified Health Center
Facility Name MAINLINE HEALTH SYSTEMS-UAM
Street 136 UNIVERSITY COURT MAXWELL HALL
City MONTICELLO
State AR
ZIP 71655
Phone 870 367-6246
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/17/2024
Certificate Expiration Date 7/16/2026
Facility Type Federally Qualified Health Center
Lab Director DR. JAMIE EVANS

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