04D1062383 CLIA NUMBER - NORTHWEST MEDICAL PLAZA AT SUGAR CREEK

Laboratory Demographics

CLIA Number: 04D1062383

Facility Name: NORTHWEST MEDICAL PLAZA AT SUGAR CREEK

Facility Address:
1102 NW LOWES AVE SUITE 2
BENTONVILLE, AR
ZIP 72712
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Facility Phone Number: (479) 254-8563

Facility Type: PHYSICIAN OFFICE

Certificate Type: Certificate of Compliance

NPI Number: 1356872758

Taxonomy: 251300000X - Local Education Agency (LEA)
The term local education agency means a public board of education or other public authority legally constituted within a State to either provide administrative control or direction of, or perform a service function for public schools serving individuals ages 0 - 21 in a state, city, county, township, school district, or other political subdivision including a combination of school districts or counties recognized in a State as an administrative agency for its public schools. An LEA may provide, or employ professional who provide, services to children included in the Individuals with Disabilities Education Act (IDEA), such services may include, but are not limited to, such medical services as physical, occupational, and speech therapy.

CLIA Record

Field Name Field Value
CLIA Number 04D1062383
LAB Type PHYSICIAN OFFICE
Facility Name NORTHWEST MEDICAL PLAZA AT SUGAR CREEK
Street 1102 NW LOWES AVE SUITE 2
City BENTONVILLE
State AR
ZIP 72712
Phone (479) 254-8563

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This page was last updated on: 5/11/2023