04D2285292 CLIA NUMBER - ARCARE 73

Laboratory Demographics

  • CLIA Code: 04D2285292
  • Facility Name: ARCARE 73
  • Facility Address: 1517 S MAIN ST
    MALVERN, AR
    ZIP 72104
  • Facility Phone: 870 347-2534
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: MS. KRISTINE M. PRUITT
  • NPI Number: 1982221065
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2285292
LAB Type Federally Qualified Health Center
Facility Name ARCARE 73
Street 1517 S MAIN ST
City MALVERN
State AR
ZIP 72104
Phone 870 347-2534
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/11/2025
Certificate Expiration Date 7/10/2027
Facility Type Federally Qualified Health Center
Lab Director MS. KRISTINE M. PRUITT

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