CLIA lab
CLIA 04D1089069: Air-Evac 12
Mountain Home, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D1089069 belongs to Air-Evac 12 in Mountain Home, AR.
Certificate of Waiver, effective September 10, 2026, expires September 9, 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
- September 10, 2026
- Certificate expiration
- September 9, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 10, 2008
- Facility type
- Ambulance
- 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
- 04D1089069
- Lab name
- Air-Evac 12
- Address
- 549 Hospital Drive, Mountain Home, AR 72653
- Phone
- (870) 508-2611
- Fax
- (870) 425-2539
Annual test volume the lab reported
- Waived tests
- 300
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Mountain Home, AR
- Access Medical Clinic Arkansas, LLCCertificate of Waiver, Physician office04D2281761
- Arcare 137Certificate of Waiver, Federally qualified health center04D2222761
- Arcare 149Certificate of Waiver, Federally qualified health center04D2329674
- Baxter HealthCertificate of Accreditation, Hospital04D0692424
- Baxter Health College Street Family ClinicCertificate of Waiver, Community clinic04D2310270
- Baxter Health Comprehensive Women's ClinicCertificate for Provider-Performed Microscopy Procedures, Community clinic04D2043524
- Baxter Health Family ClinicCertificate for Provider-Performed Microscopy Procedures, Community clinic04D2003558
- Baxter Health Market Street Family ClinicCertificate for Provider-Performed Microscopy Procedures, Community clinic04D2157727
- Baxter Health Med-Peds ClinicCertificate of Waiver, Community clinic04D2189382
- Baxter Health Nephrology ClinicCertificate for Provider-Performed Microscopy Procedures, Physician office04D2030378
Related
Questions
What is the CLIA number for Air-Evac 12 in Mountain Home?
04D1089069, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Air-Evac 12 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D1089069 expire?
The CMS file lists September 9, 2028 as the certificate expiration date; the certificate took effect September 10, 2026.