CLIA lab
CLIA 04D1041996: Wagner Medical Clinic
Manila, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D1041996 belongs to Wagner Medical Clinic in Manila, AR.
Certificate of Waiver, effective March 11, 2026, expires March 10, 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
- March 11, 2026
- Certificate expiration
- March 10, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- June 16, 2005
- 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
- 04D1041996
- Lab name
- Wagner Medical Clinic
- Address
- 3644 West State Hwy 18, Manila, AR 72442
- Phone
- (870) 561-3300
- Fax
- (870) 561-3307
Annual test volume the lab reported
- Waived tests
- 704
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Manila, AR
- Delta Behavioral HealthCertificate of Waiver, Other04D2252516
- Delta Drug, IncCertificate of Waiver, Pharmacy04D2156702
- Manila Health and RehabCertificate of Waiver, Skilled nursing or nursing facility04D0677643
- Nea Baptist Clinic ManilaCertificate of Registration, Physician office04D2342517
- ST Bernard's Laboratory - ManilaCertificate of Accreditation, Other04D2072194
- ST Bernards Urgent Care - ManilaCertificate of Waiver, Physician office04D2267791
- United Healthcare Services IncCertificate of Waiver, Mobile lab04D2293136
Related
Questions
What is the CLIA number for Wagner Medical Clinic in Manila?
04D1041996, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Wagner Medical Clinic hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D1041996 expire?
The CMS file lists March 10, 2028 as the certificate expiration date; the certificate took effect March 11, 2026.