CLIA lab
CLIA 04D2177971: Legacy Health and Wellness PLLC
Wynne, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D2177971 belongs to Legacy Health and Wellness PLLC in Wynne, AR.
Certificate of Waiver, effective January 23, 2026, expires January 22, 2028.
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
- January 23, 2026
- Certificate expiration
- January 22, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- January 23, 2020
- 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
- 04D2177971
- Lab name
- Legacy Health and Wellness PLLC
- Address
- 421 Falls Blvd S, Wynne, AR 72396
- Phone
- (870) 587-0900
- Fax
- (870) 587-0903
Annual test volume the lab reported
- Waived tests
- 20
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 Legacy Health and Wellness PLLC in Wynne?
04D2177971, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Legacy Health and Wellness PLLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D2177971 expire?
The CMS file lists January 22, 2028 as the certificate expiration date; the certificate took effect January 23, 2026.