04D2330173 CLIA NUMBER - EDEN BIRTH & WELLNESS

Laboratory Demographics

  • CLIA Code: 04D2330173
  • Facility Name: EDEN BIRTH & WELLNESS
  • Facility Address: 214 SOUTH 1ST STREET
    ROGERS, AR
    ZIP 72756
  • Facility Phone: 479 935-3392
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: PHEBE GRANDERSON
  • NPI Number: 1538739875
  • Taxonomy: 367A00000X - Advanced Practice Midwife

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CLIA Record

Field Name Field Value
CLIA Number 04D2330173
LAB Type Independent
Facility Name EDEN BIRTH & WELLNESS
Street 214 SOUTH 1ST STREET
City ROGERS
State AR
ZIP 72756
Phone 479 935-3392
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/11/2025
Certificate Expiration Date 9/10/2027
Facility Type Independent
Lab Director PHEBE GRANDERSON

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