04D2252516 CLIA NUMBER - DELTA BEHAVIORAL HEALTH

Laboratory Demographics

  • CLIA Code: 04D2252516
  • Facility Name: DELTA BEHAVIORAL HEALTH
  • Facility Address: 920 E MEDICAL DRIVE
    MANILA, AR
    ZIP 72442
  • Facility Phone: 870 570-0358
  • Facility Type: Other - BEHAVIORAL HEALTH
  • Facility Type: Waiver
  • Lab Director: MS. ANGIE MASTER
  • NPI Number: 1720637085
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2252516
LAB Type Other - BEHAVIORAL HEALTH
Facility Name DELTA BEHAVIORAL HEALTH
Street 920 E MEDICAL DRIVE
City MANILA
State AR
ZIP 72442
Phone 870 570-0358
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/11/2024
Certificate Expiration Date 2/10/2026
Facility Type Other - BEHAVIORAL HEALTH
Lab Director MS. ANGIE MASTER

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