CLIA lab
CLIA 04D1053557: Adult Medicine Clinic of Blytheville
Blytheville, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D1053557 belongs to Adult Medicine Clinic of Blytheville in Blytheville, AR.
Certificate of Waiver, effective April 27, 2026, expires April 26, 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
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
- April 27, 2026
- Certificate expiration
- April 26, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- April 27, 2006
- 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
- 04D1053557
- Lab name
- Adult Medicine Clinic of Blytheville
- Address
- 519 North 6th Street, Blytheville, AR 72315
- Phone
- (870) 762-5800
- Fax
- (870) 762-5801
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.
Other labs in Blytheville, AR
- Access Medical Clinic Arkansas LLCCertificate of Waiver, Physician office04D2289685
- Air-Evac 113Certificate of Waiver, Ambulance04D2064713
- Allied Health Connect Associates LLCCertificate of Waiver, Public health laboratory04D2288387
- B M A BlythevilleCertificate of Waiver, End stage renal disease dialysis facility04D0942154
- Constance H Smith MD PACertificate of Waiver, Physician office04D2049073
- Delta Behavioral Health LLCCertificate of Waiver, Other04D2275300
- Doc Network - Nucor Yamato Stell Clinic, theCertificate of Waiver, Physician office04D2223423
- Everside Health Blytheville Ar ClinicCertificate of Waiver, Other04D2258358
- Family Medicine Assoc of BlythevilleCertificate of Compliance, Physician office04D0467710
- Fast Pace HealthCertificate of Waiver, Other04D2305580
Related
Questions
What is the CLIA number for Adult Medicine Clinic of Blytheville in Blytheville?
04D1053557, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Adult Medicine Clinic of Blytheville hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D1053557 expire?
The CMS file lists April 26, 2028 as the certificate expiration date; the certificate took effect April 27, 2026.