CLIA lab

CLIA 04D2119425: Arkansas Occupational Health Clinic - Russellville

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

CLIA number 04D2119425 belongs to Arkansas Occupational Health Clinic - Russellville in Russellville, AR.

Certificate of Waiver, effective September 27, 2026, expires September 26, 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
September 27, 2026
Certificate expiration
September 26, 2028
Status in the CMS file
Active (termination code 00)
Original participation date
September 27, 2016
Facility type
Physician office
Ownership (control type)
Proprietary
Lab classification
CLIA laboratory
Directly affiliated labs
2

Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page

Lab and contact

CLIA number
04D2119425
Lab name
Arkansas Occupational Health Clinic - Russellville
Address
821 W 2nd Ct, Suite B, Russellville, AR 72801
Phone
(479) 219-5190
Fax
(479) 219-5191

Annual test volume the lab reported

Waived tests
1,500

Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.

Affiliated CLIA numbers

Other labs in Russellville, AR

Related

Questions

What is the CLIA number for Arkansas Occupational Health Clinic - Russellville in Russellville?

04D2119425, per the CMS Provider of Services file posted October 16, 2026.

What CLIA certificate does Arkansas Occupational Health Clinic - Russellville hold?

A Certificate of Waiver, according to the CMS file.

When does CLIA 04D2119425 expire?

The CMS file lists September 26, 2028 as the certificate expiration date; the certificate took effect September 27, 2026.

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