CLIA lab
CLIA 04D2195171: Countryside Assisted Living
Huntsville, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D2195171 belongs to Countryside Assisted Living in Huntsville, AR.
Certificate of Waiver, effective October 7, 2024, expiration date October 6, 2026.
The CMS file posted October 16, 2026 lists the certificate as active, but its expiration date has passed. A renewal may not be in this file yet.
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
- October 7, 2024
- Certificate expiration
- October 6, 2026
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- October 7, 2020
- Facility type
- Assisted living facility
- 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
- 04D2195171
- Lab name
- Countryside Assisted Living
- Address
- 722 Phillips Place, Huntsville, AR 72740
- Phone
- (479) 738-1500
- Fax
- (479) 738-1000
Annual test volume the lab reported
- Waived tests
- 100
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 Countryside Assisted Living in Huntsville?
04D2195171, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Countryside Assisted Living hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D2195171 expire?
The CMS file lists October 6, 2026 as the certificate expiration date; the certificate took effect October 7, 2024.