04D2302407 CLIA NUMBER - CAMP ALDERSGATE

Laboratory Demographics

  • CLIA Code: 04D2302407
  • Facility Name: CAMP ALDERSGATE
  • Facility Address: 2000 ALDERSGATE RD
    LITTLE ROCK, AR
    ZIP 72205
  • Facility Phone: 703 253-4923
  • Facility Type: Other - DIABETES SUMMER CAMP
  • Facility Type: Waiver
  • Lab Director: JON ODEN
  • NPI Number: 1831234178
  • Taxonomy: 385H00000X - Respite Care

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 04D2302407
LAB Type Other - DIABETES SUMMER CAMP
Facility Name CAMP ALDERSGATE
Street 2000 ALDERSGATE RD
City LITTLE ROCK
State AR
ZIP 72205
Phone 703 253-4923
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/10/2024
Certificate Expiration Date 4/9/2026
Facility Type Other - DIABETES SUMMER CAMP
Lab Director JON ODEN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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