04D2284817 CLIA NUMBER - WARREN HIGH SCHOOL CLINIC MAINLINE HEALTH SYSTEMS INC

Laboratory Demographics

  • CLIA Code: 04D2284817
  • Facility Name: WARREN HIGH SCHOOL CLINIC MAINLINE HEALTH SYSTEMS INC
  • Facility Address: 931 N MYRTLE BUILDING D
    WARREN, AR
    ZIP 71671
  • Facility Phone: 870 226-6754
  • Facility Type: School/Student Health Service
  • Facility Type: Waiver
  • Lab Director: DR. KERRY PENNINGTON
  • NPI Number: 1215700265
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2284817
LAB Type School/Student Health Service
Facility Name WARREN HIGH SCHOOL CLINIC MAINLINE HEALTH SYSTEMS INC
Street 931 N MYRTLE BUILDING D
City WARREN
State AR
ZIP 71671
Phone 870 226-6754
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/29/2025
Certificate Expiration Date 6/28/2027
Facility Type School/Student Health Service
Lab Director DR. KERRY PENNINGTON

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