04D2253098 CLIA NUMBER - MEDMARK TREATMENT CENTERS SPRINGDALE SPRINGDALE TREATMENT CENTER, LLC

Laboratory Demographics

CLIA Number: 04D2253098

Facility Name: MEDMARK TREATMENT CENTERS SPRINGDALE SPRINGDALE TREATMENT CENTER, LLC

Facility Address:
1607 S OLD MISSOURI ROAD
SPRINGDALE, AR
ZIP 72764
Get Directions

Facility Phone Number: 479 306-4480

Facility Type: Other - NARCOTIC TREATMENT PROGRA

Certificate Type: Waiver

NPI Number: 1437557899

Taxonomy: 261QM2800X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.

CLIA Record

Field Name	Field Value
CLIA Number	04D2253098
LAB Type	Other - NARCOTIC TREATMENT PROGRA
Facility Name	MEDMARK TREATMENT CENTERS SPRINGDALE SPRINGDALE TREATMENT CENTER, LLC
Street	1607 S OLD MISSOURI ROAD
City	SPRINGDALE
State	AR
ZIP	72764
Phone	479 306-4480
CertificateType	4
CertificateEffectiveDate	2/17/2024
CertificateExpirationDate	2/16/2026
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 4/23/2024