04D2246974 CLIA NUMBER - TAYLOR MADE CLINIC

Laboratory Demographics

  • CLIA Code: 04D2246974
  • Facility Name: TAYLOR MADE CLINIC
  • Facility Address: 316 EAST MAIN
    MOUNTAIN VIEW, AR
    ZIP 72560
  • Facility Phone: 870 269-8700
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: CALLIE R. TAYLOR
  • NPI Number: 1073282513
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 04D2246974
LAB Type Practitioner Other
Facility Name TAYLOR MADE CLINIC
Street 316 EAST MAIN
City MOUNTAIN VIEW
State AR
ZIP 72560
Phone 870 269-8700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/3/2024
Certificate Expiration Date 1/2/2026
Facility Type Practitioner Other
Lab Director CALLIE R. TAYLOR

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