CLIA lab
CLIA 04D0670714: Prairie Grove Health and Rehabilitation
Prairie Grove, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D0670714 belongs to Prairie Grove Health and Rehabilitation in Prairie Grove, AR.
Certificate of Waiver, effective September 1, 2026, expires August 31, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Run it in Rivvi
Map your lab's test names to LOINC codes
Open in RivviFree to start. Opens Rivvi, the AI workspace for healthcare teams.
Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- September 1, 2026
- Certificate expiration
- August 31, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- May 25, 1994
- Facility type
- Skilled nursing or nursing facility
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 04D0670714
- Lab name
- Prairie Grove Health and Rehabilitation
- Address
- 621 S Mock, Prairie Grove, AR 72753
- Phone
- (479) 846-2169
- Fax
- (479) 846-4665
Annual test volume the lab reported
- Waived tests
- 33,875
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Prairie Grove, AR
- Access Medical Clinic LLCCertificate of Waiver, Physician office04D2268884
- Collier Drug - Prairie GroveCertificate of Waiver, Pharmacy04D2275312
- Mana Family Medicine Prairie GroveCertificate for Provider-Performed Microscopy Procedures, Physician office04D0930326
- Prairie Grove School Based Health CenterCertificate for Provider-Performed Microscopy Procedures, Federally qualified health center04D2062313
Related
Questions
What is the CLIA number for Prairie Grove Health and Rehabilitation in Prairie Grove?
04D0670714, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Prairie Grove Health and Rehabilitation hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D0670714 expire?
The CMS file lists August 31, 2028 as the certificate expiration date; the certificate took effect September 1, 2026.