OrganizationPathology Labs Of ArClinical Medical LaboratoryLaboratoriesPractice Address1 Lile Ct, Suite 101, Little Rock, AR 72205-6242(501) 225-7711PECOS EnrollmentBased on the most recent information from CMS, provider Pathology Labs Of Ar does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1275778219Provider TypeOrganizationFull NamePathology Labs Of ArSubpartNoEnumeration Date12/4/2008Last Updated12/4/2008Contact InformationPractice LocationPractice Address1 Lile Ct, Suite 101, Little Rock, AR 72205-6242Phone(501) 225-7711Fax(501) 225-7108Mailing LocationMailing Address1 Lile Ct, Suite 101, Little Rock, AR 72205-6242Phone(501) 225-7711Fax(501) 225-7108Authorized OfficialNameMiller, Keith E (Administrator)Phone(501) 225-7711Provider TaxonomiesCodeDescriptionLicenseCode291U00000XPrimaryDescriptionClinical Medical LaboratoryLaboratoriesLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID18132DescriptionOtherIssuerMEDICARE PTANArkansasID104544002DescriptionMedicaidIssuerUnlistedArkansas