CLIA lab
CLIA 04D2166609: Lifetime Wellness LTD
Bentonville, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D2166609 belongs to Lifetime Wellness LTD in Bentonville, AR.
Certificate of Waiver, effective May 21, 2025, expires May 20, 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
- May 21, 2025
- Certificate expiration
- May 20, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- May 21, 2019
- 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
- 04D2166609
- Lab name
- Lifetime Wellness LTD
- Address
- 1206 E Moberly Ln, Ste 8, Bentonville, AR 72712
- Phone
- (479) 876-5500
Annual test volume the lab reported
- Waived tests
- 1,800
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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Related
Questions
What is the CLIA number for Lifetime Wellness LTD in Bentonville?
04D2166609, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Lifetime Wellness LTD hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D2166609 expire?
The CMS file lists May 20, 2027 as the certificate expiration date; the certificate took effect May 21, 2025.