CLIA lab
CLIA 04D2209681: Palace Drug
Mammoth Spring, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D2209681 belongs to Palace Drug in Mammoth Spring, AR.
Certificate of Waiver, effective January 15, 2025, expires January 14, 2027.
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 15, 2025
- Certificate expiration
- January 14, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- January 15, 2021
- Facility type
- Pharmacy
- 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
- 04D2209681
- Lab name
- Palace Drug
- Additional name
- Burns RX LLC
- Address
- 270 Main St, Mammoth Spring, AR 72554
- Phone
- (870) 625-3222
- Fax
- (870) 625-3216
Annual test volume the lab reported
- Waived tests
- 200
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Mammoth Spring, AR
Related
Questions
What is the CLIA number for Palace Drug in Mammoth Spring?
04D2209681, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Palace Drug hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D2209681 expire?
The CMS file lists January 14, 2027 as the certificate expiration date; the certificate took effect January 15, 2025.