04D2293074 CLIA NUMBER - STREAMLINE IMMEDIATE CARE

Laboratory Demographics

  • CLIA Code: 04D2293074
  • Facility Name: STREAMLINE IMMEDIATE CARE
  • Facility Address: 221 EAST 4TH STREET
    RUSSELLVILLE, AR
    ZIP 72801
  • Facility Phone: 479 567-5770
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JEREMY SAUL
  • NPI Number: 1508233701
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 04D2293074
LAB Type Physician Office
Facility Name STREAMLINE IMMEDIATE CARE
Street 221 EAST 4TH STREET
City RUSSELLVILLE
State AR
ZIP 72801
Phone 479 567-5770
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/2/2023
Certificate Expiration Date 11/1/2025
Facility Type Physician Office
Lab Director JEREMY SAUL

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