CLIA lab
CLIA 04D2193405: Bentonville Ambulatory Surgery Center
Bentonville, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D2193405 belongs to Bentonville Ambulatory Surgery Center in Bentonville, AR.
Certificate of Waiver, effective September 21, 2026, expires September 20, 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
- September 21, 2026
- Certificate expiration
- September 20, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 21, 2020
- Facility type
- Ambulatory surgery center
- 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
- 04D2193405
- Lab name
- Bentonville Ambulatory Surgery Center
- Address
- 2902 SE Mid-Cities Drive, Bentonville, AR 72712
- Phone
- (501) 322-7993
- Fax
- (888) 630-8885
Annual test volume the lab reported
- Waived tests
- 300
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Arcare - BentonvilleCertificate of Waiver, Federally qualified health center04D2049893
- Arcare 33 Bentonville MedicalCertificate of Waiver, Federally qualified health center04D2187506
- 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 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
- Biomat USA IncCertificate of Accreditation, Other04D2234552
Related
Questions
What is the CLIA number for Bentonville Ambulatory Surgery Center in Bentonville?
04D2193405, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Bentonville Ambulatory Surgery Center hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D2193405 expire?
The CMS file lists September 20, 2028 as the certificate expiration date; the certificate took effect September 21, 2026.