CLIA lab
CLIA 04D2162005: Connelley Family Medical, PLLC
Monticello, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D2162005 belongs to Connelley Family Medical, PLLC in Monticello, AR.
Certificate of Waiver, effective February 14, 2025, expires February 13, 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
- February 14, 2025
- Certificate expiration
- February 13, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- February 14, 2019
- Facility type
- Other practitioner
- 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
- 04D2162005
- Lab name
- Connelley Family Medical, PLLC
- Address
- 1222 Old Warren Road, Suite A, Monticello, AR 71655
- Phone
- (870) 460-9001
- Fax
- (870) 412-4575
Annual test volume the lab reported
- Waived tests
- 5,200
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Centers for Youth & Families, theCertificate of Waiver, Other04D2056378
- Centerwell Home HealthCertificate of Waiver, Home health agency04D2116741
- Chi ST Vincent Heart Clinic Arkansas MonticelloCertificate of Waiver, Physician office04D2159493
- Clear Choice Diagnostic CenterCertificate of Waiver, Independent04D2255521
- Clinic Pharmacy of MonticelloCertificate of Waiver, Pharmacy04D2313009
- Cornerstone Clinic for Women - MonticelloCertificate of Waiver, Physician office04D2343900
- Delta Counseling Associates IncCertificate of Waiver, Other04D2246753
- Drew Central School Based ClinicCertificate of Waiver, School or student health service04D2136227
- Drew County LaboratoryCertificate of Compliance, Hospital04D0693675
Related
Questions
What is the CLIA number for Connelley Family Medical, PLLC in Monticello?
04D2162005, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Connelley Family Medical, PLLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D2162005 expire?
The CMS file lists February 13, 2027 as the certificate expiration date; the certificate took effect February 14, 2025.