04D2321048 CLIA NUMBER - TRUSTT MEDICAL PLLC

Laboratory Demographics

  • CLIA Code: 04D2321048
  • Facility Name: TRUSTT MEDICAL PLLC
  • Facility Address: 903 SE 28TH ST SUITE 3
    BENTONVILLE, AR
    ZIP 72712
  • Facility Phone: 479 366-3574
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SCOTT R. MUSICK
  • NPI Number: 1366149791
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 04D2321048
LAB Type Physician Office
Facility Name TRUSTT MEDICAL PLLC
Street 903 SE 28TH ST SUITE 3
City BENTONVILLE
State AR
ZIP 72712
Phone 479 366-3574
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/28/2025
Certificate Expiration Date 3/27/2027
Facility Type Physician Office
Lab Director SCOTT R. MUSICK

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