CLIA lab
CLIA 04D0687904: Ozark Dermatology Clinic
Fayetteville, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D0687904 belongs to Ozark Dermatology Clinic in Fayetteville, AR.
Certificate of Compliance, effective January 12, 2025, expires January 11, 2027.
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 Compliance
- Certificate effective
- January 12, 2025
- Certificate expiration
- January 11, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 1, 1992
- Facility type
- Physician office
- 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
- 04D0687904
- Lab name
- Ozark Dermatology Clinic
- Address
- 4375 N Vantage Dr Ste 305, Fayetteville, AR 72703
- Phone
- (479) 443-5100
- Fax
- (479) 443-5117
Annual test volume the lab reported
- Waived tests
- 480
- Provider-performed microscopy tests
- 290
- Other nonwaived tests
- 42,816
- Total
- 43,586
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Fayetteville, AR
- Abernathy ClinicCertificate for Provider-Performed Microscopy Procedures, Physician office04D1036891
- Accent Women's HealthCertificate for Provider-Performed Microscopy Procedures, Physician office04D1087975
- Advanced Dermatology & Skin Cancer CenterCertificate of Compliance, Physician office04D1094440
- Advanced Health and Wellness ICertificate of Waiver, Federally qualified health center04D2294418
- Ancient Birth TraditionCertificate of Waiver, Other practitioner04D2220559
- Arcare 96Certificate of Waiver, Federally qualified health center04D2308355
- Arkansas Outpatient Eye Surgery LLCCertificate of Waiver, Ambulatory surgery center04D1048911
- Arkansas Veterans Home at FayettevilleCertificate of Waiver, Skilled nursing or nursing facility04D2095155
- Aurora Rehabilitation ClinicCertificate of Waiver, Comprehensive outpatient rehab facility04D2269408
- BHG Medical Services - FayettevilleCertificate of Waiver, Other04D2173843
Related
Questions
What is the CLIA number for Ozark Dermatology Clinic in Fayetteville?
04D0687904, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Ozark Dermatology Clinic hold?
A Certificate of Compliance, according to the CMS file.
When does CLIA 04D0687904 expire?
The CMS file lists January 11, 2027 as the certificate expiration date; the certificate took effect January 12, 2025.