04D2310595 CLIA NUMBER - CROSS HOPE BY RESTAURA

Laboratory Demographics

  • CLIA Code: 04D2310595
  • Facility Name: CROSS HOPE BY RESTAURA
  • Facility Address: 1301 RIDGWAY ROAD UNIT 1C
    PINE BLUFF, AR
    ZIP 71603
  • Facility Phone: 870 395-7341
  • Facility Type: Other - OFFICE BASED OPIOID TREAT
  • Facility Type: Waiver
  • Lab Director: TRISHA E. BLAIR
  • NPI Number: 1104663889
  • Taxonomy: 261QR0405X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 04D2310595
LAB Type Other - OFFICE BASED OPIOID TREAT
Facility Name CROSS HOPE BY RESTAURA
Street 1301 RIDGWAY ROAD UNIT 1C
City PINE BLUFF
State AR
ZIP 71603
Phone 870 395-7341
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/6/2024
Certificate Expiration Date 9/5/2026
Facility Type Other - OFFICE BASED OPIOID TREAT
Lab Director TRISHA E. BLAIR

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