CLIA lab
CLIA 04D0920989: Crestpark Dewitt LLC
De Witt, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D0920989 belongs to Crestpark Dewitt LLC in De Witt, AR.
Certificate of Waiver, effective October 16, 2026, expires October 15, 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
- October 16, 2026
- Certificate expiration
- October 15, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- October 16, 1996
- Facility type
- Skilled nursing or nursing 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
- 04D0920989
- Lab name
- Crestpark Dewitt LLC
- Address
- 1325 Liberty Drive, De Witt, AR 72042
- Phone
- (870) 946-3569
Annual test volume the lab reported
- Waived tests
- 2,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Care facility at this address
- Crestpark Dewitt, LLCCMS Care Compare ratings for the facility at the same street address
Other labs in De Witt, AR
- Baptist Health - Family Clinic DewittCertificate of Waiver, Rural health clinic04D1028354
- Burleson Family Practice ClinicCertificate for Provider-Performed Microscopy Procedures, Physician office04D0929711
- Dean's PharmacyCertificate of Waiver, Pharmacy04D2188792
- Dewitt Hospital and Nursing HomeCertificate of Compliance, Hospital04D0642180
- Dewitt Nursing HomeCertificate of Waiver, Skilled nursing or nursing facility04D2191054
- Ferguson Rural Health ClinicCertificate of Waiver, Rural health clinic04D0702095
- Mid-Delta Health Systems - DewittCertificate for Provider-Performed Microscopy Procedures, Federally qualified health center04D0677682
Related
Questions
What is the CLIA number for Crestpark Dewitt LLC in De Witt?
04D0920989, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Crestpark Dewitt LLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D0920989 expire?
The CMS file lists October 15, 2028 as the certificate expiration date; the certificate took effect October 16, 2026.