04D2196601 CLIA NUMBER - EMBRACE FMO LLC

Laboratory Demographics

  • CLIA Code: 04D2196601
  • Facility Name: EMBRACE FMO LLC
  • Facility Address: 1502 SE 28TH ST, SUITE 2
    BENTONVILLE, AR
    ZIP 72712
  • Facility Phone: 479 286-4774
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JENNIFER SCHROEDER
  • NPI Number: 1417554015
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 04D2196601
LAB Type Physician Office
Facility Name EMBRACE FMO LLC
Street 1502 SE 28TH ST, SUITE 2
City BENTONVILLE
State AR
ZIP 72712
Phone 479 286-4774
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/19/2024
Certificate Expiration Date 10/18/2026
Facility Type Physician Office
Lab Director DR. JENNIFER SCHROEDER

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