04D2303241 CLIA NUMBER - BRADLEY BIBB MD PLLC

Laboratory Demographics

  • CLIA Code: 04D2303241
  • Facility Name: BRADLEY BIBB MD PLLC
  • Facility Address: 3809 EAST 9TH ST SUITE 15
    TEXARKANA, AR
    ZIP 71854
  • Facility Phone: 870 621-0080
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MARK HAHN
  • NPI Number: 1871346064
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2303241
LAB Type Physician Office
Facility Name BRADLEY BIBB MD PLLC
Street 3809 EAST 9TH ST SUITE 15
City TEXARKANA
State AR
ZIP 71854
Phone 870 621-0080
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/23/2024
Certificate Expiration Date 4/22/2026
Facility Type Physician Office
Lab Director DR. MARK HAHN

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