CLIA lab
CLIA 04D2171476: Eaglecrest Recovery LLC
Bentonville, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D2171476 belongs to Eaglecrest Recovery LLC in Bentonville, AR.
Certificate of Waiver, effective September 3, 2025, expires September 2, 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
- September 3, 2025
- Certificate expiration
- September 2, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 3, 2019
- Facility type
- Other
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 1
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 04D2171476
- Lab name
- Eaglecrest Recovery LLC
- Address
- 1101 SW Coventry Blvd, Bentonville, AR 72712
- Phone
- (949) 813-5161
- Fax
- (479) 367-2899
Annual test volume the lab reported
- Waived tests
- 503
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Benton County Dialysis CenterCertificate of Waiver, End stage renal disease dialysis facility04D1037079
- Benton County Home DialysisCertificate of Waiver, End stage renal disease dialysis facility04D2115280
- Bentonville Ambulatory Surgery CenterCertificate of Waiver, Ambulatory surgery center04D2193405
- Bentonville DialysisCertificate of Waiver, End stage renal disease dialysis facility04D0922944
- Bentonville Endoscopy Center LLCCertificate of Waiver, Ambulatory surgery center04D2315853
- Bentonville Fire DepartmentCertificate of Waiver, Ambulance04D0882445
- Bentonville PediatricsCertificate of Waiver, Physician office04D1002649
Related
Questions
What is the CLIA number for Eaglecrest Recovery LLC in Bentonville?
04D2171476, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Eaglecrest Recovery LLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D2171476 expire?
The CMS file lists September 2, 2027 as the certificate expiration date; the certificate took effect September 3, 2025.