CLIA lab

CLIA 04D2140355: Baptist Health Family Clinic Russellville

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

CLIA number 04D2140355 belongs to Baptist Health Family Clinic Russellville in Russellville, AR.

Certificate of Waiver, effective November 20, 2025, expires November 19, 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
November 20, 2025
Certificate expiration
November 19, 2027
Status in the CMS file
Active (termination code 00)
Original participation date
November 20, 2017
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
04D2140355
Lab name
Baptist Health Family Clinic Russellville
Address
1605 West Main Street, Russellville, AR 72801
Phone
(479) 219-5008
Fax
(479) 219-5025

Annual test volume the lab reported

Waived tests
2,100

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

Other labs in Russellville, AR

Related

Questions

What is the CLIA number for Baptist Health Family Clinic Russellville in Russellville?

04D2140355, per the CMS Provider of Services file posted October 16, 2026.

What CLIA certificate does Baptist Health Family Clinic Russellville hold?

A Certificate of Waiver, according to the CMS file.

When does CLIA 04D2140355 expire?

The CMS file lists November 19, 2027 as the certificate expiration date; the certificate took effect November 20, 2025.

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