CLIA lab
CLIA 04D1073729: Ozark Dermatology Clinic
Bentonville, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D1073729 belongs to Ozark Dermatology Clinic in Bentonville, AR.
Certificate of Compliance, effective June 20, 2026, expires June 19, 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 Compliance
- Certificate effective
- June 20, 2026
- Certificate expiration
- June 19, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 14, 2007
- Facility type
- Physician office
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 3
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 04D1073729
- Lab name
- Ozark Dermatology Clinic
- Address
- 901 SE 22nd St, Bentonville, AR 72712
- Phone
- (479) 273-7006
- Fax
- (479) 443-5117
Annual test volume the lab reported
- Waived tests
- 245
- Provider-performed microscopy tests
- 99
- Other nonwaived tests
- 325
- Total
- 669
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 Ozark Dermatology Clinic in Bentonville?
04D1073729, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Ozark Dermatology Clinic hold?
A Certificate of Compliance, according to the CMS file.
When does CLIA 04D1073729 expire?
The CMS file lists June 19, 2028 as the certificate expiration date; the certificate took effect June 20, 2026.