CLIA lab
CLIA 04D1107657: Boston Mountain Rural Health Clinic - Green Forest
Green Forest, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D1107657 belongs to Boston Mountain Rural Health Clinic - Green Forest in Green Forest, AR.
Certificate of Waiver, effective December 28, 2024, expires December 27, 2026.
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
- December 28, 2024
- Certificate expiration
- December 27, 2026
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- November 10, 2009
- Facility type
- Federally qualified health center
- Ownership (control type)
- Other
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 4
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 04D1107657
- Lab name
- Boston Mountain Rural Health Clinic - Green Forest
- Address
- 1103 West Main Street, Green Forest, AR 72638
- Phone
- (870) 438-6500
- Fax
- (870) 438-6615
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.
Affiliated CLIA numbers
Other labs in Green Forest, AR
Related
Questions
What is the CLIA number for Boston Mountain Rural Health Clinic - Green Forest in Green Forest?
04D1107657, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Boston Mountain Rural Health Clinic - Green Forest hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D1107657 expire?
The CMS file lists December 27, 2026 as the certificate expiration date; the certificate took effect December 28, 2024.