CLIA lab
CLIA 04D2202721: Bungalows at Fayetteville, the
Fayetteville, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D2202721 belongs to Bungalows at Fayetteville, the in Fayetteville, AR.
Certificate of Waiver, effective December 1, 2024, expires November 30, 2026.
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 1, 2024
- Certificate expiration
- November 30, 2026
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- December 1, 2020
- Facility type
- Assisted living facility
- Ownership (control type)
- Private
- 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
- 04D2202721
- Lab name
- Bungalows at Fayetteville, the
- Address
- 4461 N Crossover Road, Fayetteville, AR 72703
- Phone
- (479) 443-1908
- Fax
- (479) 443-1808
Annual test volume the lab reported
- Waived tests
- 700
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 Bungalows at Fayetteville, the in Fayetteville?
04D2202721, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Bungalows at Fayetteville, the hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D2202721 expire?
The CMS file lists November 30, 2026 as the certificate expiration date; the certificate took effect December 1, 2024.