04D2233680 CLIA NUMBER - MAINLINE HEALTH SYSTEMS SHERIDAN HIGH SCHOOL CLINIC

Laboratory Demographics

  • CLIA Code: 04D2233680
  • Facility Name: MAINLINE HEALTH SYSTEMS SHERIDAN HIGH SCHOOL CLINIC
  • Facility Address: 512 WEST CHURCH STREET STE A
    SHERIDAN, AR
    ZIP 72150
  • Facility Phone: 870 942-3000
  • Facility Type: School/Student Health Service
  • Facility Type: Waiver
  • Lab Director: DR. KERRY PENNINGTON
  • NPI Number: 1104574219
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2233680
LAB Type School/Student Health Service
Facility Name MAINLINE HEALTH SYSTEMS SHERIDAN HIGH SCHOOL CLINIC
Street 512 WEST CHURCH STREET STE A
City SHERIDAN
State AR
ZIP 72150
Phone 870 942-3000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/25/2025
Certificate Expiration Date 8/24/2027
Facility Type School/Student Health Service
Lab Director DR. KERRY PENNINGTON

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