CLIA lab
CLIA 04D2122289: Jonesboro Pediatric Clinic, LLC
Jonesboro, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D2122289 belongs to Jonesboro Pediatric Clinic, LLC in Jonesboro, AR.
Certificate of Waiver, effective June 9, 2025, expires June 8, 2027.
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
- June 9, 2025
- Certificate expiration
- June 8, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- November 23, 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
- 04D2122289
- Lab name
- Jonesboro Pediatric Clinic, LLC
- Address
- 616 Southwest Drive, Jonesboro, AR 72401
- Phone
- (870) 333-5721
- Fax
- (870) 333-5722
Annual test volume the lab reported
- Waived tests
- 195
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Jonesboro, AR
- Apache Drive Children's ClinicCertificate of Waiver, Physician office04D0875868
- Ar Anatomic Pathology Laboratory/Doctors'Certificate of Compliance, Independent04D0892601
- Arcare - JonesboroCertificate of Waiver, Federally qualified health center04D2049891
- Arcare 141Certificate of Waiver, Federally qualified health center04D2243446
- Arcare 160Certificate of Waiver, Federally qualified health center04D2326381
- Arcare 172Certificate of Waiver, Physician office04D2105851
- Arcare 22Certificate of Waiver, Federally qualified health center04D2008012
- Arcare 55Certificate of Waiver, Federally qualified health center04D1036366
- Arcare 59Certificate of Waiver, Federally qualified health center04D2114808
- Arisa Health IncCertificate of Waiver, Other04D2021886
Related
Questions
What is the CLIA number for Jonesboro Pediatric Clinic, LLC in Jonesboro?
04D2122289, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Jonesboro Pediatric Clinic, LLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D2122289 expire?
The CMS file lists June 8, 2027 as the certificate expiration date; the certificate took effect June 9, 2025.