CLIA lab
CLIA 04D2176842: Jefferson Regional Monticello Medical Clinic 2
Monticello, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D2176842 belongs to Jefferson Regional Monticello Medical Clinic 2 in Monticello, AR.
Certificate of Waiver, effective December 27, 2025, expires December 26, 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
- December 27, 2025
- Certificate expiration
- December 26, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- December 27, 2019
- Facility type
- Rural health clinic
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 3
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 04D2176842
- Lab name
- Jefferson Regional Monticello Medical Clinic 2
- Address
- 733 Roberts Drive, Monticello, AR 71655
- Phone
- (870) 460-4766
- Fax
- (870) 367-1467
Annual test volume the lab reported
- Waived tests
- 4,200
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Affiliated CLIA numbers
Other labs in Monticello, AR
- Belle View Estates Rehab-CareCertificate of Waiver, Skilled nursing or nursing facility04D2009491
- 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
- Connelley Family Medical, PLLCCertificate of Waiver, Other practitioner04D2162005
- 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
Related
Questions
What is the CLIA number for Jefferson Regional Monticello Medical Clinic 2 in Monticello?
04D2176842, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Jefferson Regional Monticello Medical Clinic 2 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D2176842 expire?
The CMS file lists December 26, 2027 as the certificate expiration date; the certificate took effect December 27, 2025.