CLIA lab

CLIA 04D2162298: Tyson Poultry, Inc - Pine Bluff, Ar

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

CLIA number 04D2162298 belongs to Tyson Poultry, Inc - Pine Bluff, Ar in Pine Bluff, AR.

Certificate of Waiver, effective February 20, 2025, expires February 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
February 20, 2025
Certificate expiration
February 19, 2027
Status in the CMS file
Active (termination code 00)
Original participation date
February 20, 2019
Facility type
Other
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
04D2162298
Lab name
Tyson Poultry, Inc - Pine Bluff, Ar
Address
5505 Jefferson Parkway, Pine Bluff, AR 71602
Phone
(870) 247-6024
Fax
(479) 717-8984

Annual test volume the lab reported

Waived tests
1,600

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

Other labs in Pine Bluff, AR

Related

Questions

What is the CLIA number for Tyson Poultry, Inc - Pine Bluff, Ar in Pine Bluff?

04D2162298, per the CMS Provider of Services file posted October 16, 2026.

What CLIA certificate does Tyson Poultry, Inc - Pine Bluff, Ar hold?

A Certificate of Waiver, according to the CMS file.

When does CLIA 04D2162298 expire?

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

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