CLIA lab
CLIA 04D0700111: Mana Family Medicine North / Renaissance Medical
Fayetteville, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D0700111 belongs to Mana Family Medicine North / Renaissance Medical in Fayetteville, AR.
Certificate for Provider-Performed Microscopy Procedures, effective September 26, 2025, expires September 25, 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 for Provider-Performed Microscopy Procedures
- Certificate effective
- September 26, 2025
- Certificate expiration
- September 25, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- May 4, 1994
- 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
- 04D0700111
- Lab name
- Mana Family Medicine North / Renaissance Medical
- Additional name
- Associates of Northwest Arkansas
- Address
- 688 Millsap Rd Suite 101, Fayetteville, AR 72703
- Phone
- (479) 443-3536
- Fax
- (479) 443-3933
Annual test volume the lab reported
- Waived tests
- 3,800
- Provider-performed microscopy tests
- 220
- Total
- 4,020
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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Related
Questions
What is the CLIA number for Mana Family Medicine North / Renaissance Medical in Fayetteville?
04D0700111, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Mana Family Medicine North / Renaissance Medical hold?
A Certificate for Provider-Performed Microscopy Procedures, according to the CMS file.
When does CLIA 04D0700111 expire?
The CMS file lists September 25, 2027 as the certificate expiration date; the certificate took effect September 26, 2025.