CLIA lab
CLIA 04D1089243: Nutt-Walley Clinic of Dallas County
Fordyce, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D1089243 belongs to Nutt-Walley Clinic of Dallas County in Fordyce, AR.
Certificate of Waiver, effective September 12, 2026, expires September 11, 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 12, 2026
- Certificate expiration
- September 11, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 12, 2008
- Facility type
- Rural health clinic
- Ownership (control type)
- Government, county
- 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
- 04D1089243
- Lab name
- Nutt-Walley Clinic of Dallas County
- Address
- 110 North Clifton, Fordyce, AR 71742
- Phone
- (870) 352-3525
- Fax
- (870) 352-3533
Annual test volume the lab reported
- Waived tests
- 2,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Fordyce, AR
- Dallas County Medical CenterCertificate of Compliance, Hospital04D0689262
- Dcmc Family ClinicCertificate of Waiver, Rural health clinic04D1066528
- Elite Home HealthCertificate of Waiver, Home health agency04D0698540
- Millcreek of ArkansasCertificate of Waiver, Intermediate care facility for individuals with intellectual disabilities04D1027329
- Millcreek of Arkansas ICF MRCertificate of Waiver, Intermediate care facility for individuals with intellectual disabilities04D2010339
- ST John's Place of Arkansas LLCCertificate of Waiver, Skilled nursing or nursing facility04D1066504
- Walmart Pharmacy 10-0339Certificate of Waiver, Pharmacy04D2139457
Related
Questions
What is the CLIA number for Nutt-Walley Clinic of Dallas County in Fordyce?
04D1089243, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Nutt-Walley Clinic of Dallas County hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D1089243 expire?
The CMS file lists September 11, 2028 as the certificate expiration date; the certificate took effect September 12, 2026.