CLIA lab
CLIA 04D1078433: Tri-Lakes Services, Inc
Gillham, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D1078433 belongs to Tri-Lakes Services, Inc in Gillham, AR.
Certificate of Waiver, effective January 9, 2026, expires January 8, 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
- January 9, 2026
- Certificate expiration
- January 8, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- January 9, 2008
- Facility type
- Other
- Ownership (control type)
- Private
- 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
- 04D1078433
- Lab name
- Tri-Lakes Services, Inc
- Address
- 111 N 2nd Street, Gillham, AR 71841
- Phone
- (870) 386-2451
- Fax
- (870) 386-2071
Annual test volume the lab reported
- Waived tests
- 200
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Related
Questions
What is the CLIA number for Tri-Lakes Services, Inc in Gillham?
04D1078433, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Tri-Lakes Services, Inc hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D1078433 expire?
The CMS file lists January 8, 2028 as the certificate expiration date; the certificate took effect January 9, 2026.