04D2267882 CLIA NUMBER - SELAH HEALTH

Laboratory Demographics

  • CLIA Code: 04D2267882
  • Facility Name: SELAH HEALTH
  • Facility Address: 180 S THORNTON AVE
    PIGGOTT, AR
    ZIP 72454
  • Facility Phone: 870 970-3180
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AMANDA SMALLMON
  • NPI Number: 1720734247
  • Taxonomy: 363LP0808X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 04D2267882
LAB Type Physician Office
Facility Name SELAH HEALTH
Street 180 S THORNTON AVE
City PIGGOTT
State AR
ZIP 72454
Phone 870 970-3180
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director AMANDA SMALLMON

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