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04D2286434 CLIA NUMBER - BAXTER HEALTH REPELL DIABETES CLINIC

Laboratory Demographics

CLIA Number: 04D2286434

Facility Name: BAXTER HEALTH REPELL DIABETES CLINIC

Facility Address:
622 BROADMORE DRIVE
MOUNTAIN HOME, AR
ZIP 72653
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Facility Phone Number: 870 508-1765

Facility Type: Community Clinic

Certificate Type: Waiver
NPI Number: 1710541289

Taxonomy: 261QP2000X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic and treatment services related to physical rehabilitation. Physical therapy is a dynamic profession with an established theoretical and scientific base and widespread clinical applications in the restoration, maintenance, and promotion of optimal physical function. Physical therapists and physical therapist assistants are licensed health care professionals who are experts in the movement system and help individuals maintain, restore, and improve movement, activity, and functioning, thereby enabling optimal performance and enhancing health, well-being, and quality of life. Their services prevent, minimize, or eliminate impairments of body functions and structures, activity limitations, and participation restrictions. Physical therapy is provided for individuals of all ages who have or may develop impairments, activity limitations, and participation restrictions related to (1) conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems or (2) the negative effects attributable to unique personal and environmental factors as they relate to human performance.

CLIA Record

Field Name Field Value
CLIA Number 04D2286434
LAB Type Community Clinic
Facility Name BAXTER HEALTH REPELL DIABETES CLINIC
Street 622 BROADMORE DRIVE
City MOUNTAIN HOME
State AR
ZIP 72653
Phone 870 508-1765
CertificateType 4
CertificateEffectiveDate 7/28/2023
CertificateExpirationDate 7/27/2025
FacilityType Waiver

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