CLIA lab

CLIA 04D2112078: Arkansas Renal Group, PA - Russellville

Russellville, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.

CLIA number 04D2112078 belongs to Arkansas Renal Group, PA - Russellville in Russellville, AR.

Certificate of Waiver, effective April 21, 2026, expires April 20, 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
April 21, 2026
Certificate expiration
April 20, 2028
Status in the CMS file
Active (termination code 00)
Original participation date
April 21, 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
04D2112078
Lab name
Arkansas Renal Group, PA - Russellville
Address
111 Skyline Drive, Russellville, AR 72801
Phone
(501) 624-6000
Fax
(501) 321-0710

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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Questions

What is the CLIA number for Arkansas Renal Group, PA - Russellville in Russellville?

04D2112078, per the CMS Provider of Services file posted October 16, 2026.

What CLIA certificate does Arkansas Renal Group, PA - Russellville hold?

A Certificate of Waiver, according to the CMS file.

When does CLIA 04D2112078 expire?

The CMS file lists April 20, 2028 as the certificate expiration date; the certificate took effect April 21, 2026.

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