CLIA lab
CLIA 04D2196227: Montogomery County Assisted Living
Mount Ida, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D2196227 belongs to Montogomery County Assisted Living in Mount Ida, AR.
Certificate of Waiver, effective October 15, 2026, expires October 14, 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
Run it in Rivvi
Map your lab's test names to LOINC codes
Open in RivviFree to start. Opens Rivvi, the AI workspace for healthcare teams.
Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- October 15, 2026
- Certificate expiration
- October 14, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- October 15, 2020
- Facility type
- Other
- Ownership (control type)
- Other
- 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
- 04D2196227
- Lab name
- Montogomery County Assisted Living
- Address
- 147 Senior Drive, Mount Ida, AR 71957
- Phone
- (870) 867-2159
- Fax
- (870) 867-3177
Annual test volume the lab reported
- Waived tests
- 250
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Mount Ida, AR
- Chi ST Vincent Medcial Group Hot SpringsCertificate of Compliance, Physician office04D0466068
- Healthy Connections-Montgomery Community ClinicCertificate of Waiver, Federally qualified health center04D1078542
- Montgomery County Nursing HomeCertificate of Waiver, Skilled nursing or nursing facility04D0883592
- Wagner's Mount Ida PharmacyCertificate of Waiver, Pharmacy04D2138568
Related
Questions
What is the CLIA number for Montogomery County Assisted Living in Mount Ida?
04D2196227, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Montogomery County Assisted Living hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D2196227 expire?
The CMS file lists October 14, 2028 as the certificate expiration date; the certificate took effect October 15, 2026.