CLIA lab
CLIA 04D2009219: Southern Trace Rehab-Care CTR
Bryant, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D2009219 belongs to Southern Trace Rehab-Care CTR in Bryant, 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
Run it in Rivvi
Map your lab's test names to LOINC codes
Open in RivviFree to start. Opens Rivvi, the AI workspace for healthcare teams.
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
- 04D2009219
- Lab name
- Southern Trace Rehab-Care CTR
- Additional name
- Bryant SNF Operations LLC
- Address
- 22515 Interstate 30, Bryant, AR 72022
- Phone
- (501) 847-0777
- Fax
- (501) 847-5276
Annual test volume the lab reported
- Waived tests
- 5,800
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Bryant, AR
- Ames Direct Primary CareCertificate for Provider-Performed Microscopy Procedures, Physician office04D2248564
- Anna Katherine Ross MSN Apn P ACertificate of Waiver, Community clinic04D2204663
- Arcare 76Certificate of Waiver, Federally qualified health center04D2283745
- Arkansas Heart Hospital Clinic - SalineCertificate of Waiver, Physician office04D2039283
- Arkansas Heart Hospital Llc-EncoreCertificate of Compliance, Hospital04D2196275
- Arkansas Pediatric ClinicCertificate of Waiver, Physician office04D2107564
- Baptist Health Family Clinic BryantCertificate of Compliance, Physician office04D0466177
- Baptist Health Urgent Care-Bryant, ArCertificate of Waiver, Physician office04D2105408
- Bryant Eyecare ClinicCertificate of Waiver, Physician office04D1098523
- Bryant Family Clinic PACertificate for Provider-Performed Microscopy Procedures, Physician office04D0891906
Related
Questions
What is the CLIA number for Southern Trace Rehab-Care CTR in Bryant?
04D2009219, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Southern Trace Rehab-Care CTR hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D2009219 expire?
The CMS file lists June 28, 2028 as the certificate expiration date; the certificate took effect June 29, 2026.