04D2318166 CLIA NUMBER - PINNACLE GASTROENTEROLOGY

Laboratory Demographics

  • CLIA Code: 04D2318166
  • Facility Name: PINNACLE GASTROENTEROLOGY
  • Facility Address: 409 N UNIVERSITY
    LITTLE ROCK, AR
    ZIP 72205
  • Facility Phone: 501 246-4561
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. CHUN FAN
  • NPI Number: 1952528648
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 04D2318166
LAB Type Physician Office
Facility Name PINNACLE GASTROENTEROLOGY
Street 409 N UNIVERSITY
City LITTLE ROCK
State AR
ZIP 72205
Phone 501 246-4561
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/6/2025
Certificate Expiration Date 2/5/2027
Facility Type Physician Office
Lab Director DR. CHUN FAN

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