CLIA lab
CLIA 04D1062383: Northwest Medical Plaza at Sugar Creek
Bentonville, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D1062383 belongs to Northwest Medical Plaza at Sugar Creek in Bentonville, 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
- December 13, 2006
- Facility type
- Physician office
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 1
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 04D1062383
- Lab name
- Northwest Medical Plaza at Sugar Creek
- Address
- 1102 NW Lowes Ave, Suite 2, Bentonville, AR 72712
- Phone
- (479) 553-2464
- Fax
- (479) 254-8564
Annual test volume the lab reported
- Waived tests
- 6,200
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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 DialysisCertificate of Waiver, End stage renal disease dialysis facility04D0922944
- Bentonville Endoscopy Center LLCCertificate of Waiver, Ambulatory surgery center04D2315853
- Bentonville Fire DepartmentCertificate of Waiver, Ambulance04D0882445
- Bentonville PediatricsCertificate of Waiver, Physician office04D1002649
Related
Questions
What is the CLIA number for Northwest Medical Plaza at Sugar Creek in Bentonville?
04D1062383, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Northwest Medical Plaza at Sugar Creek hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D1062383 expire?
The CMS file lists October 15, 2027 as the certificate expiration date; the certificate took effect October 16, 2025.