04D2274760 CLIA NUMBER - BAXTER HEALTH UROLOGY CLINIC AT HARRISON

Laboratory Demographics

  • CLIA Code: 04D2274760
  • Facility Name: BAXTER HEALTH UROLOGY CLINIC AT HARRISON
  • Facility Address: 715 W SHERMAN AVE SUITE A
    HARRISON, AR
    ZIP 72601
  • Facility Phone: 870 741-2317
  • Facility Type: Community Clinic
  • Facility Type: Microscopy
  • Lab Director: SCOTT FERGUSON
  • NPI Number: 1356976047
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 04D2274760
LAB Type Community Clinic
Facility Name BAXTER HEALTH UROLOGY CLINIC AT HARRISON
Street 715 W SHERMAN AVE SUITE A
City HARRISON
State AR
ZIP 72601
Phone 870 741-2317
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/10/2025
Certificate Expiration Date 1/9/2027
Facility Type Community Clinic
Lab Director SCOTT FERGUSON

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