CLIA lab
CLIA 04D0922944: Bentonville Dialysis
Bentonville, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D0922944 belongs to Bentonville Dialysis in Bentonville, AR.
Certificate of Waiver, effective December 10, 2024, expires December 9, 2026.
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
- December 10, 2024
- Certificate expiration
- December 9, 2026
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- December 10, 1996
- Facility type
- End stage renal disease dialysis facility
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 3
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 04D0922944
- Lab name
- Bentonville Dialysis
- Address
- 1104 SE 30th St, Bentonville, AR 72712
- Phone
- (479) 657-6220
- Fax
- (479) 657-6229
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
- DaVita Bentonville DialysisCMS Care Compare ratings for the facility at the same street address
Affiliated CLIA numbers
Other labs in Bentonville, AR
- Advanced Dermatology & Skin Cancer CenterCertificate for Provider-Performed Microscopy Procedures, Physician office04D2081659
- Arcare - BentonvilleCertificate of Waiver, Federally qualified health center04D2049893
- Arcare 33 Bentonville MedicalCertificate of Waiver, Federally qualified health center04D2187506
- Benton County Dialysis CenterCertificate of Waiver, End stage renal disease dialysis facility04D1037079
- Benton County Home DialysisCertificate of Waiver, End stage renal disease dialysis facility04D2115280
- Bentonville Ambulatory Surgery CenterCertificate of Waiver, Ambulatory surgery center04D2193405
- Bentonville Endoscopy Center LLCCertificate of Waiver, Ambulatory surgery center04D2315853
- Bentonville Fire DepartmentCertificate of Waiver, Ambulance04D0882445
- Bentonville PediatricsCertificate of Waiver, Physician office04D1002649
- Biomat USA IncCertificate of Accreditation, Other04D2234552
Related
Questions
What is the CLIA number for Bentonville Dialysis in Bentonville?
04D0922944, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Bentonville Dialysis hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D0922944 expire?
The CMS file lists December 9, 2026 as the certificate expiration date; the certificate took effect December 10, 2024.