04D2325162 CLIA NUMBER - ARCARE 155

Laboratory Demographics

  • CLIA Code: 04D2325162
  • Facility Name: ARCARE 155
  • Facility Address: 4747 DUSTY LANE DRIVE SUITE G1
    PINE BLUFF, AR
    ZIP 71603
  • Facility Phone: 870 641-2991
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: KRISTINE M. PRUITT
  • NPI Number: 1407744642
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2325162
LAB Type Federally Qualified Health Center
Facility Name ARCARE 155
Street 4747 DUSTY LANE DRIVE SUITE G1
City PINE BLUFF
State AR
ZIP 71603
Phone 870 641-2991
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/9/2025
Certificate Expiration Date 6/8/2027
Facility Type Federally Qualified Health Center
Lab Director KRISTINE M. PRUITT

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