04D0889073 CLIA NUMBER - BOSTON MOUNTAIN RURAL HEALTH CENTER,INC-HUNTSVILLE

Laboratory Demographics

  • CLIA Code: 04D0889073
  • Facility Name: BOSTON MOUNTAIN RURAL HEALTH CENTER,INC-HUNTSVILLE
  • Facility Address: 934 NORTH GASKILL STREET
    HUNTSVILLE, AR
    ZIP 72740
  • Facility Phone: 479 738-5500
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. LARRY B. JENNINGS
  • NPI Number: 1467543892
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D0889073
LAB Type Federally Qualified Health Center
Facility Name BOSTON MOUNTAIN RURAL HEALTH CENTER,INC-HUNTSVILLE
Street 934 NORTH GASKILL STREET
City HUNTSVILLE
State AR
ZIP 72740
Phone 479 738-5500
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 4/6/2025
Certificate Expiration Date 4/5/2027
Facility Type Federally Qualified Health Center
Lab Director DR. LARRY B. JENNINGS

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This page was last updated on: 3/20/2025