04D2285292 CLIA NUMBER - ARCARE 73

Laboratory Demographics

CLIA Number: 04D2285292

Facility Name: ARCARE 73

Facility Address:
1517 SOUTH MAIN STREET
MALVERN, AR
ZIP 72104
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Facility Phone Number: 870 347-2534

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1982221065

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	04D2285292
LAB Type	Federally Qualified Health Center
Facility Name	ARCARE 73
Street	1517 SOUTH MAIN STREET
City	MALVERN
State	AR
ZIP	72104
Phone	870 347-2534
CertificateType	4
CertificateEffectiveDate	7/11/2023
CertificateExpirationDate	7/10/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024