CLIA lab
CLIA 04D1019297: Main Street Medical
Benton, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D1019297 belongs to Main Street Medical in Benton, AR.
Certificate of Waiver, effective November 17, 2025, expires November 16, 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
Run it in Rivvi
Map your lab's test names to LOINC codes
Open in RivviFree to start. Opens Rivvi, the AI workspace for healthcare teams.
Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- November 17, 2025
- Certificate expiration
- November 16, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- November 17, 2003
- 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
- 04D1019297
- Lab name
- Main Street Medical
- Address
- 722 North Main Street, Benton, AR 72015
- Phone
- (501) 315-0059
- Fax
- (501) 315-1320
Annual test volume the lab reported
- Waived tests
- 300
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Benton, AR
- Alcoa Pines Health & RehabilitationCertificate of Waiver, Skilled nursing or nursing facility04D1045183
- Amberwood Health and RehabilitationCertificate of Waiver, Skilled nursing or nursing facility04D2140547
- Arcare 121Certificate of Waiver, Federally qualified health center04D2160874
- 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 Main Street Medical in Benton?
04D1019297, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Main Street Medical hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D1019297 expire?
The CMS file lists November 16, 2027 as the certificate expiration date; the certificate took effect November 17, 2025.