CLIA lab
CLIA 04D2011490: TLC Pediatrics, PLLC
Conway, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D2011490 belongs to TLC Pediatrics, PLLC in Conway, AR.
Certificate of Waiver, effective August 17, 2026, expires August 16, 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
- August 17, 2026
- Certificate expiration
- August 16, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- August 17, 2010
- Facility type
- Physician office
- 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
- 04D2011490
- Lab name
- TLC Pediatrics, PLLC
- Address
- 955 Carolyn Lane, Conway, AR 72034
- Phone
- (201) 327-2444
- Fax
- (501) 327-2443
Annual test volume the lab reported
- Waived tests
- 2,500
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Amy R Hudson, MDCertificate of Compliance, Other04D2063453
- Arcare 24Certificate of Waiver, Federally qualified health center04D2034996
- Aristotle Diagnostic Laboratories LLCCertificate of Accreditation, Independent04D2253867
- Arkansas DermatologyCertificate of Compliance, Physician office04D2028520
- Arkansas Heart Hospital Clinic - ConwayCertificate of Waiver, Physician office04D2090186
- Arkansas Pediatrics of ConwayCertificate of Compliance, Physician office04D0913091
- Arkansas Urology - ConwayCertificate for Provider-Performed Microscopy Procedures, Physician office04D2140908
- Aveon Renal Care, LLCCertificate of Waiver, End stage renal disease dialysis facility04D2338583
Related
Questions
What is the CLIA number for TLC Pediatrics, PLLC in Conway?
04D2011490, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does TLC Pediatrics, PLLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D2011490 expire?
The CMS file lists August 16, 2028 as the certificate expiration date; the certificate took effect August 17, 2026.