CLIA lab
CLIA 04D2009218: Lake Village Rehab-Care CTR
Lake Village, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D2009218 belongs to Lake Village Rehab-Care CTR in Lake Village, AR.
Certificate of Waiver, effective June 29, 2026, expires June 28, 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
- June 29, 2026
- Certificate expiration
- June 28, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- June 29, 2010
- Facility type
- Skilled nursing or nursing facility
- 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
- 04D2009218
- Lab name
- Lake Village Rehab-Care CTR
- Additional name
- Lake Village Operations LLC
- Address
- 903 Borgognoni Drive, Lake Village, AR 71653
- Phone
- (870) 265-5337
- Fax
- (870) 265-3275
Annual test volume the lab reported
- Waived tests
- 5,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Care facility at this address
- Lake Village Rehabilitation and Care CenterCMS Care Compare ratings for the facility at the same street address
Other labs in Lake Village, AR
- Chicot Memorial Medical CenterCertificate of Compliance, Hospital04D0465387
- Chicot Memorial Medical Center Home HealthCertificate of Waiver, Home health agency04D0681352
- Hunter's Pharmacy, IncCertificate of Waiver, Pharmacy04D1095104
- Lake Village ClinicCertificate of Waiver, Physician office04D0693694
- Lake Village School Based ClinicCertificate of Waiver, School or student health service04D2126174
- Lakeside High School Based ClinicCertificate of Waiver, School or student health service04D2142136
- Pathway Recovery DevelopmentCertificate of Waiver, Comprehensive outpatient rehab facility04D2312252
- Southeast Rehabilitation HospitalCertificate of Waiver, Hospital04D1059020
- Southeast Rural Health ClinicCertificate of Waiver, Rural health clinic04D2183693
Related
Questions
What is the CLIA number for Lake Village Rehab-Care CTR in Lake Village?
04D2009218, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Lake Village Rehab-Care CTR hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D2009218 expire?
The CMS file lists June 28, 2028 as the certificate expiration date; the certificate took effect June 29, 2026.