04D2305213 CLIA NUMBER - BAXTER HEALTH UROLOGY CLINIC

Laboratory Demographics

  • CLIA Code: 04D2305213
  • Facility Name: BAXTER HEALTH UROLOGY CLINIC
  • Facility Address: 15 GREEN VALLEY DRIVE SUITE 100
    MOUNTAIN HOME, AR
    ZIP 72653
  • Facility Phone: 870 701-0490
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: JASON T. LINDSAY
  • NPI Number: 1982450706
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 04D2305213
LAB Type Community Clinic
Facility Name BAXTER HEALTH UROLOGY CLINIC
Street 15 GREEN VALLEY DRIVE SUITE 100
City MOUNTAIN HOME
State AR
ZIP 72653
Phone 870 701-0490
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/28/2024
Certificate Expiration Date 5/27/2026
Facility Type Community Clinic
Lab Director JASON T. LINDSAY

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