CLIA lab
CLIA 04D0693694: Lake Village Clinic
Lake Village, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D0693694 belongs to Lake Village Clinic in Lake Village, AR.
Certificate of Waiver, effective August 8, 2025, expires August 7, 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
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- August 8, 2025
- Certificate expiration
- August 7, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- January 7, 1993
- Facility type
- Physician office
- Ownership (control type)
- Other
- 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
- 04D0693694
- Lab name
- Lake Village Clinic
- Additional name
- Chicot Memorial Medical Center
- Address
- 2918 Louis Sessions Street, Lake Village, AR 71653
- Phone
- (870) 265-5343
- Fax
- (870) 265-5686
Annual test volume the lab reported
- Waived tests
- 100
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Lake Village, AR
- Chicot Memorial Medical CenterCertificate of Compliance, Hospital04D0465387
- Chicot Memorial Medical Center Home HealthCertificate of Waiver, Home health agency04D0681352
- Hunter's Pharmacy, IncCertificate of Waiver, Pharmacy04D1095104
- Lake Village Rehab-Care CTRCertificate of Waiver, Skilled nursing or nursing facility04D2009218
- Lake Village School Based ClinicCertificate of Waiver, School or student health service04D2126174
- Lakeside High School Based ClinicCertificate of Waiver, School or student health service04D2142136
- Pathway Recovery DevelopmentCertificate of Waiver, Comprehensive outpatient rehab facility04D2312252
- Southeast Rehabilitation HospitalCertificate of Waiver, Hospital04D1059020
- Southeast Rural Health ClinicCertificate of Waiver, Rural health clinic04D2183693
Related
Questions
What is the CLIA number for Lake Village Clinic in Lake Village?
04D0693694, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Lake Village Clinic hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D0693694 expire?
The CMS file lists August 7, 2027 as the certificate expiration date; the certificate took effect August 8, 2025.