04D2278522 CLIA NUMBER - OZARK PELVIC HEALTH, LLC

Laboratory Demographics

  • CLIA Code: 04D2278522
  • Facility Name: OZARK PELVIC HEALTH, LLC
  • Facility Address: 19 MEDICAL PLAZA
    MOUNTAIN HOME, AR
    ZIP 72653
  • Facility Phone: 870 232-0948
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. WILLAM COREY SMITH
  • NPI Number: 1598463572
  • Taxonomy: 207VG0400X - Obstetrics & Gynecology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 04D2278522
LAB Type Physician Office
Facility Name OZARK PELVIC HEALTH, LLC
Street 19 MEDICAL PLAZA
City MOUNTAIN HOME
State AR
ZIP 72653
Phone 870 232-0948
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 3/20/2025
Certificate Expiration Date 3/19/2027
Facility Type Physician Office
Lab Director DR. WILLAM COREY SMITH

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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