CLIA lab
CLIA 04D0869630: Jefferson County Dialysis Inc
Pine Bluff, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D0869630 belongs to Jefferson County Dialysis Inc in Pine Bluff, 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
- May 20, 1993
- Facility type
- End stage renal disease dialysis 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
- 04D0869630
- Lab name
- Jefferson County Dialysis Inc
- Address
- 2910 Market Street, Pine Bluff, AR 71601
- Phone
- (870) 534-2233
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
- Fmcna - Pine BluffCMS Care Compare ratings for the facility at the same street address
Other labs in Pine Bluff, AR
- Ach Pine Bluff ClinicCertificate of Waiver, Physician office04D0465263
- Arcare 140Certificate of Waiver, Federally qualified health center04D2349439
- Arcare 155Certificate of Waiver, Federally qualified health center04D2325162
- Archwell Health - Pine BluffCertificate of Waiver, Physician office04D2315883
- Arkansas Dept of Correction Health SVCCertificate of Waiver, Other02D0682823
- Autonomy Healthcare ProvidersCertificate of Waiver, Physician office04D2271274
- Buckhanan RecoveryCertificate of Waiver, Other04D2299468
- Cavhs Pine BluffCertificate of Accreditation, Community clinic04D2185025
- Central Arkansas Radiation Therapy InstituteCertificate of Accreditation, Physician office04D2194416
- Children's Advocacy Center of Southeast ArkansasCertificate of Waiver, Other04D2275776
Related
Questions
What is the CLIA number for Jefferson County Dialysis Inc in Pine Bluff?
04D0869630, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Jefferson County Dialysis Inc hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D0869630 expire?
The CMS file lists August 31, 2028 as the certificate expiration date; the certificate took effect September 1, 2026.