04D2234361 CLIA NUMBER - CENTER CONVENIENT CARE, PLC HOLISTIC HEALTH AND HYDRATION PLLC

Laboratory Demographics

  • CLIA Code: 04D2234361
  • Facility Name: CENTER CONVENIENT CARE, PLC HOLISTIC HEALTH AND HYDRATION PLLC
  • Facility Address: 107 S CRAVENS
    CLARKSVILLE, AR
    ZIP 72830
  • Facility Phone: 479 774-4695
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: REBEKAH K. MIZE
  • NPI Number: 1558060327
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 04D2234361
LAB Type Practitioner Other
Facility Name CENTER CONVENIENT CARE, PLC HOLISTIC HEALTH AND HYDRATION PLLC
Street 107 S CRAVENS
City CLARKSVILLE
State AR
ZIP 72830
Phone 479 774-4695
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/31/2025
Certificate Expiration Date 8/30/2027
Facility Type Practitioner Other
Lab Director REBEKAH K. MIZE

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