CLIA lab
CLIA 04D1064024: Heritage Square Healthcare Center
Blytheville, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D1064024 belongs to Heritage Square Healthcare Center in Blytheville, AR.
Certificate of Waiver, effective January 26, 2025, expires January 25, 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
- January 26, 2025
- Certificate expiration
- January 25, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- January 26, 2007
- Facility type
- Skilled nursing or nursing facility
- 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
- 04D1064024
- Lab name
- Heritage Square Healthcare Center
- Address
- 710 North Ruddle Road, Blytheville, AR 72315
- Phone
- (870) 763-3654
- Fax
- (870) 762-1172
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- Family Medicine Assoc of BlythevilleCertificate of Compliance, Physician office04D0467710
Related
Questions
What is the CLIA number for Heritage Square Healthcare Center in Blytheville?
04D1064024, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Heritage Square Healthcare Center hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D1064024 expire?
The CMS file lists January 25, 2027 as the certificate expiration date; the certificate took effect January 26, 2025.