04D2246604 CLIA NUMBER - COUNSELING CLINIC INC

Laboratory Demographics

  • CLIA Code: 04D2246604
  • Facility Name: COUNSELING CLINIC INC
  • Facility Address: 110 PEARSON ST
    BENTON, AR
    ZIP 72015
  • Facility Phone: 501 326-6750
  • Facility Type: Other - MENTAL HEALTH FACILITY
  • Facility Type: Waiver
  • Lab Director: TONY SISSON
  • NPI Number: 1649267659
  • Taxonomy: 2084P0800X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 04D2246604
LAB Type Other - MENTAL HEALTH FACILITY
Facility Name COUNSELING CLINIC INC
Street 110 PEARSON ST
City BENTON
State AR
ZIP 72015
Phone 501 326-6750
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/28/2023
Certificate Expiration Date 12/27/2025
Facility Type Other - MENTAL HEALTH FACILITY
Lab Director TONY SISSON

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