CLIA lab
CLIA 04D0683491: Indian Rock Village, LLC
Fairfield Bay, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D0683491 belongs to Indian Rock Village, LLC in Fairfield Bay, 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
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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
- January 4, 1993
- Facility type
- Skilled nursing or nursing facility
- Ownership (control type)
- Religious affiliation
- 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
- 04D0683491
- Lab name
- Indian Rock Village, LLC
- Address
- 265 Dave Creek Pkwy, Fairfield Bay, AR 72088
- Phone
- (501) 884-3210
- Fax
- (501) 884-6800
Annual test volume the lab reported
- Waived tests
- 500
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Care facility at this address
- The Springs of Fairfield BayCMS Care Compare ratings for the facility at the same street address
Other labs in Fairfield Bay, AR
Related
Questions
What is the CLIA number for Indian Rock Village, LLC in Fairfield Bay?
04D0683491, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Indian Rock Village, LLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D0683491 expire?
The CMS file lists August 31, 2028 as the certificate expiration date; the certificate took effect September 1, 2026.