CLIA lab
CLIA 04D2010339: Millcreek of Arkansas ICF MR
Fordyce, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D2010339 belongs to Millcreek of Arkansas ICF MR in Fordyce, AR.
Certificate of Waiver, effective July 26, 2026, expires July 25, 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
- July 26, 2026
- Certificate expiration
- July 25, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- July 26, 2010
- Facility type
- Intermediate care facility for individuals with intellectual disabilities
- Ownership (control type)
- Private
- 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
- 04D2010339
- Lab name
- Millcreek of Arkansas ICF MR
- Address
- 1214 Moro St, Fordyce, AR 71742
- Phone
- (870) 352-7176
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 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
- Nutt-Walley Clinic of Dallas CountyCertificate of Waiver, Rural health clinic04D1089243
- 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 Millcreek of Arkansas ICF MR in Fordyce?
04D2010339, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Millcreek of Arkansas ICF MR hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D2010339 expire?
The CMS file lists July 25, 2028 as the certificate expiration date; the certificate took effect July 26, 2026.