04D2208279 CLIA NUMBER - EUSTASIS PSYCHIATRIC AND ADDICTION HEALTH

Laboratory Demographics

  • CLIA Code: 04D2208279
  • Facility Name: EUSTASIS PSYCHIATRIC AND ADDICTION HEALTH
  • Facility Address: 2005 W ELM ST
    ROGERS, AR
    ZIP 72758
  • Facility Phone: 479 427-7722
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALISHA JAIN
  • NPI Number: 1548760820
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2208279
LAB Type Physician Office
Facility Name EUSTASIS PSYCHIATRIC AND ADDICTION HEALTH
Street 2005 W ELM ST
City ROGERS
State AR
ZIP 72758
Phone 479 427-7722
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/5/2025
Certificate Expiration Date 1/4/2027
Facility Type Physician Office
Lab Director ALISHA JAIN

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