CLARKSVILLE MEDICAL GROUP, P.A.
NPI 1417009374
Clinical Medical Laboratory in Clarksville, AR

Active since January 18, 2007CLIA 04D0469031 · Certificate of Compliance
601 W MCKENNON ST, CLARKSVILLE, AR 72830(479) 754-8384(479) 754-7141 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Clarksville Medical Group, P.a. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLARKSVILLE MEDICAL GROUP, P.A. (NPI 1417009374) is a healthcare organization registered as a clinical medical laboratory in Clarksville, Arkansas and active in the NPI registry since January 2007. The organization holds a CLIA Certificate of Compliance certificate valid through December 9, 2027 and lists Leanna J Perrett, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1417009374
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NameCLARKSVILLE MEDICAL GROUP, P.A.
Location Address601 W MCKENNON STClarksville, AR 72830-3523
Mailing AddressPo Box 668Clarksville, AR 72830-0668 · (479) 754-8384 · Fax (479) 754-7141
Fax(479) 754-7141
Organization SubpartNo
Authorized OfficialLeanna J PerrettOffice Manager · (479) 754-8384
Enumeration DateJanuary 18, 2007
Last NPPES UpdateAugust 22, 2020
NPI 1417009374 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
License Licensed in AR · MC0283
Definition
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.
601 W MCKENNON ST, Clarksville, AR 72830

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 04D0469031

Clarksville Medical Group, PA · Clarksville, AR
Active · expires Dec 9, 2027
CLIA Number04D0469031
Laboratory TypePhysician Office
Certificate Effective DateDecember 10, 2025
Certificate Expiration DateDecember 9, 2027
Laboratory DirectorShawn A. Little
Laboratory Phone(479) 754-8384
Laboratory LocationClarksville Medical Group, PA601 W Mckennon St, Clarksville, AR 72830
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Primary Care)
601 W MCKENNON ST
CLARKSVILLE, AR 72830
Family Medicine
601 W MCKENNON ST
CLARKSVILLE, AR 72830
Family Medicine
601 W MCKENNON ST
CLARKSVILLE, AR 72830
Family Medicine
601 W MCKENNON ST
CLARKSVILLE, AR 72830
Nurse Practitioner (Family)
601 W MCKENNON ST
CLARKSVILLE, AR 72830
Family Medicine
601 W MCKENNON ST
CLARKSVILLE, AR 72830
Family Medicine
601 W MCKENNON ST
CLARKSVILLE, AR 72830
Durable Medical Equipment & Medical Supplies
601 W MCKENNON ST
CLARKSVILLE, AR 72830

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Clarksville Medical Group, P.A.'s NPI number?

The NPI number for Clarksville Medical Group, P.A. is 1417009374. It was assigned to this organization in the NPPES registry on January 18, 2007.

Where is Clarksville Medical Group, P.A. located?

Clarksville Medical Group, P.A. is located at 601 W Mckennon St, Clarksville, AR 72830. The listed phone number is (479) 754-8384.

What is Clarksville Medical Group, P.A.'s specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

Does Clarksville Medical Group, P.A. hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 04D0469031) is associated with this NPI, valid through December 9, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Clarksville Medical Group, P.A. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.