04D2242380 CLIA NUMBER - COVENANT HEALTHCARE LLC

Laboratory Demographics

  • CLIA Code: 04D2242380
  • Facility Name: COVENANT HEALTHCARE LLC
  • Facility Address: 1580 TANNER ST
    ROCKPORT, AR
    ZIP 72104
  • Facility Phone: 501 229-2920
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MICHAEL S. HIGGINBOTHAM
  • NPI Number: 1326710468
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2242380
LAB Type Physician Office
Facility Name COVENANT HEALTHCARE LLC
Street 1580 TANNER ST
City ROCKPORT
State AR
ZIP 72104
Phone 501 229-2920
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/8/2023
Certificate Expiration Date 11/7/2025
Facility Type Physician Office
Lab Director DR. MICHAEL S. HIGGINBOTHAM

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