04D2303173 CLIA NUMBER - BAXTER HEALTH COCHRAN INTERNAL MEDICINE CLINIC

Laboratory Demographics

  • CLIA Code: 04D2303173
  • Facility Name: BAXTER HEALTH COCHRAN INTERNAL MEDICINE CLINIC
  • Facility Address: 277 MAIN ST SUITE 2
    MAMMOTH SPRING, AR
    ZIP 72554
  • Facility Phone: 870 907-7024
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. CHRISTOPHER WEBB
  • NPI Number: 1689432304
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 04D2303173
LAB Type Physician Office
Facility Name BAXTER HEALTH COCHRAN INTERNAL MEDICINE CLINIC
Street 277 MAIN ST SUITE 2
City MAMMOTH SPRING
State AR
ZIP 72554
Phone 870 907-7024
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/22/2024
Certificate Expiration Date 4/21/2026
Facility Type Physician Office
Lab Director DR. CHRISTOPHER WEBB

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