04D2296588 CLIA NUMBER - HAERTLING FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 04D2296588
  • Facility Name: HAERTLING FAMILY PRACTICE
  • Facility Address: 940 23RD ST
    BATESVILLE, AR
    ZIP 72501
  • Facility Phone: 870 569-4341
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: ERIC B. HAERTLING
  • NPI Number: 1821789785
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 04D2296588
LAB Type Practitioner Other
Facility Name HAERTLING FAMILY PRACTICE
Street 940 23RD ST
City BATESVILLE
State AR
ZIP 72501
Phone 870 569-4341
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/2/2024
Certificate Expiration Date 1/1/2026
Facility Type Practitioner Other
Lab Director ERIC B. HAERTLING

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