04D2298058 CLIA NUMBER - ROLLER SURGICAL CENTER RWL MEDICAL SERVICES LLC

Laboratory Demographics

  • CLIA Code: 04D2298058
  • Facility Name: ROLLER SURGICAL CENTER RWL MEDICAL SERVICES LLC
  • Facility Address: 1695 E RAINFOREST ROAD
    FAYETTEVILLE, AR
    ZIP 72703
  • Facility Phone: 479 445-6460
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MS. CAROL GORE
  • NPI Number: 1083477582
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2298058
LAB Type Ambulatory Surgery Center
Facility Name ROLLER SURGICAL CENTER RWL MEDICAL SERVICES LLC
Street 1695 E RAINFOREST ROAD
City FAYETTEVILLE
State AR
ZIP 72703
Phone 479 445-6460
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/26/2024
Certificate Expiration Date 1/25/2026
Facility Type Ambulatory Surgery Center
Lab Director MS. CAROL GORE

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