04D2327772 CLIA NUMBER - PRESTIGE CARE

Laboratory Demographics

  • CLIA Code: 04D2327772
  • Facility Name: PRESTIGE CARE
  • Facility Address: 160 GREENE 721 RD APT D
    PARAGOULD, AR
    ZIP 72450
  • Facility Phone: 870 472-8403
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. BENJAMIN CARLYLE
  • NPI Number: 1922899368
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 04D2327772
LAB Type Physician Office
Facility Name PRESTIGE CARE
Street 160 GREENE 721 RD APT D
City PARAGOULD
State AR
ZIP 72450
Phone 870 472-8403
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/29/2025
Certificate Expiration Date 7/28/2027
Facility Type Physician Office
Lab Director DR. BENJAMIN CARLYLE

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