CLIA lab
CLIA 04D0936265: Salem Family Practice Clinic, P A
Benton, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D0936265 belongs to Salem Family Practice Clinic, P A in Benton, AR.
Certificate of Waiver, effective October 16, 2025, expires October 15, 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
- October 16, 2025
- Certificate expiration
- October 15, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- November 18, 1997
- 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
- 04D0936265
- Lab name
- Salem Family Practice Clinic, P A
- Address
- 6640 Congo Road, Benton, AR 72019
- Phone
- (501) 794-4110
- Fax
- (501) 316-9360
Annual test volume the lab reported
- Waived tests
- 2,500
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Amberwood Health and RehabilitationCertificate of Waiver, Skilled nursing or nursing facility04D2140547
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- Archer - Knight Health and Wellness, PLLCCertificate of Waiver, Other practitioner04D2317688
- Arkansas Cardiology BentonCertificate of Waiver, Physician office04D2347965
- Arkansas Health CenterCertificate of Waiver, Skilled nursing or nursing facility04D0677254
- Arkansas Urology-BentonCertificate for Provider-Performed Microscopy Procedures, Physician office04D0466136
- Baptist Health Imaging CTR Saline CountyCertificate of Waiver, Other04D2027600
- Baptist Health Urgent Care-Benton, ArCertificate of Waiver, Physician office04D2136064
- Benton DialysisCertificate of Waiver, End stage renal disease dialysis facility04D0955645
Related
Questions
What is the CLIA number for Salem Family Practice Clinic, P A in Benton?
04D0936265, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Salem Family Practice Clinic, P A hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D0936265 expire?
The CMS file lists October 15, 2027 as the certificate expiration date; the certificate took effect October 16, 2025.