04D2329674 CLIA NUMBER - ARCARE 149

Laboratory Demographics

  • CLIA Code: 04D2329674
  • Facility Name: ARCARE 149
  • Facility Address: 1405 HWY 62 WEST
    MOUNTAIN HOME, AR
    ZIP 72653
  • Facility Phone: 870 706-3421
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: KRISTINE M. PRUITT
  • NPI Number: 1023981834
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2329674
LAB Type Federally Qualified Health Center
Facility Name ARCARE 149
Street 1405 HWY 62 WEST
City MOUNTAIN HOME
State AR
ZIP 72653
Phone 870 706-3421
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/4/2025
Certificate Expiration Date 9/3/2027
Facility Type Federally Qualified Health Center
Lab Director KRISTINE M. PRUITT

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