CLIA lab
CLIA 04D2139457: Walmart Pharmacy 10-0339
Fordyce, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D2139457 belongs to Walmart Pharmacy 10-0339 in Fordyce, AR.
Certificate of Waiver, effective November 3, 2025, expires November 2, 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
Run it in Rivvi
Map your lab's test names to LOINC codes
Open in RivviFree to start. Opens Rivvi, the AI workspace for healthcare teams.
Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- November 3, 2025
- Certificate expiration
- November 2, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- November 3, 2017
- Facility type
- Pharmacy
- 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
- 04D2139457
- Lab name
- Walmart Pharmacy 10-0339
- Address
- 1123 Hwy 79 167 Bypass, Fordyce, AR 71742
- Phone
- (870) 352-8034
- Fax
- (870) 352-5495
Annual test volume the lab reported
- Waived tests
- 5,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Fordyce, AR
- Dallas County Medical CenterCertificate of Compliance, Hospital04D0689262
- Dcmc Family ClinicCertificate of Waiver, Rural health clinic04D1066528
- Elite Home HealthCertificate of Waiver, Home health agency04D0698540
- Millcreek of ArkansasCertificate of Waiver, Intermediate care facility for individuals with intellectual disabilities04D1027329
- Millcreek of Arkansas ICF MRCertificate of Waiver, Intermediate care facility for individuals with intellectual disabilities04D2010339
- Nutt-Walley Clinic of Dallas CountyCertificate of Waiver, Rural health clinic04D1089243
- ST John's Place of Arkansas LLCCertificate of Waiver, Skilled nursing or nursing facility04D1066504
Related
Questions
What is the CLIA number for Walmart Pharmacy 10-0339 in Fordyce?
04D2139457, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Walmart Pharmacy 10-0339 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D2139457 expire?
The CMS file lists November 2, 2027 as the certificate expiration date; the certificate took effect November 3, 2025.