04D2273446 CLIA NUMBER - EAGLECREST RECOVERY LLC

Laboratory Demographics

  • CLIA Code: 04D2273446
  • Facility Name: EAGLECREST RECOVERY LLC
  • Facility Address: 19965 LAKEVIEW RD
    SPRINGDALE, AR
    ZIP 72764
  • Facility Phone: 479 685-7374
  • Facility Type: Other - RESIDENT DRUG & ALCOHOL
  • Facility Type: Waiver
  • Lab Director: DR. JACOB BOYDSTUN
  • NPI Number: 1174252985
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 04D2273446
LAB Type Other - RESIDENT DRUG & ALCOHOL
Facility Name EAGLECREST RECOVERY LLC
Street 19965 LAKEVIEW RD
City SPRINGDALE
State AR
ZIP 72764
Phone 479 685-7374
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/13/2024
Certificate Expiration Date 12/12/2026
Facility Type Other - RESIDENT DRUG & ALCOHOL
Lab Director DR. JACOB BOYDSTUN

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