04D2218199 CLIA NUMBER - VAN BUREN DIALYSIS CENTER

Laboratory Demographics

  • CLIA Code: 04D2218199
  • Facility Name: VAN BUREN DIALYSIS CENTER
  • Facility Address: 256 NORTHRIDGE DRIVE E
    VAN BUREN, AR
    ZIP 72956
  • Facility Phone: 479 755-6700
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: SHERRY L. MAY
  • NPI Number: 1942300355
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 04D2218199
LAB Type Federally Qualified Health Center
Facility Name VAN BUREN DIALYSIS CENTER
Street 256 NORTHRIDGE DRIVE E
City VAN BUREN
State AR
ZIP 72956
Phone 479 755-6700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/26/2025
Certificate Expiration Date 3/25/2027
Facility Type Federally Qualified Health Center
Lab Director SHERRY L. MAY

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This page was last updated on: 6/4/2025