CLIA lab
CLIA 04D2169482: Clarksville Family Pharmacy
Clarksville, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D2169482 belongs to Clarksville Family Pharmacy in Clarksville, AR.
Certificate of Waiver, effective July 22, 2025, expires July 21, 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
- July 22, 2025
- Certificate expiration
- July 21, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- July 22, 2019
- 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
- 04D2169482
- Lab name
- Clarksville Family Pharmacy
- Address
- 510 S Rogers St Suite 3, Clarksville, AR 72830
- Phone
- (479) 647-3138
- Fax
- (479) 647-3144
Annual test volume the lab reported
- Waived tests
- 60
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Archway Chiropractic ClinicCertificate of Waiver, Other practitioner04D2132489
- Arkansas Dermatology CenterCertificate for Provider-Performed Microscopy Procedures, Physician office04D2280333
- Center Convenient Care, PLCCertificate of Waiver, Other practitioner04D2234361
- Clarksville Community Health CenterCertificate for Provider-Performed Microscopy Procedures, Federally qualified health center04D2163797
- Clarksville Family Medical CenterCertificate for Provider-Performed Microscopy Procedures, Physician office04D0970176
- Clarksville Medical Group, PACertificate of Compliance, Physician office04D0469031
- Clarksville Women's CenterCertificate for Provider-Performed Microscopy Procedures, Physician office04D2063541
Related
Questions
What is the CLIA number for Clarksville Family Pharmacy in Clarksville?
04D2169482, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Clarksville Family Pharmacy hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D2169482 expire?
The CMS file lists July 21, 2027 as the certificate expiration date; the certificate took effect July 22, 2025.