CLIA lab
CLIA 04D2107564: Arkansas Pediatric Clinic
Bryant, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D2107564 belongs to Arkansas Pediatric Clinic in Bryant, AR.
Certificate of Waiver, effective January 15, 2026, expires January 14, 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
- January 15, 2026
- Certificate expiration
- January 14, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- January 15, 2016
- 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
- 04D2107564
- Lab name
- Arkansas Pediatric Clinic
- Address
- 23157 Interstate 30 S, Suite 101, Bryant, AR 72022
- Phone
- (501) 664-4117
- Fax
- (501) 603-9390
Annual test volume the lab reported
- Waived tests
- 100
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Arkansas Heart Hospital Clinic - SalineCertificate of Waiver, Physician office04D2039283
- Arkansas Heart Hospital Llc-EncoreCertificate of Compliance, Hospital04D2196275
- 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
- Bryant Family PharmacyCertificate of Waiver, Pharmacy04D2134510
Related
Questions
What is the CLIA number for Arkansas Pediatric Clinic in Bryant?
04D2107564, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Arkansas Pediatric Clinic hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D2107564 expire?
The CMS file lists January 14, 2028 as the certificate expiration date; the certificate took effect January 15, 2026.