CLIA lab
CLIA 04D2216511: Cvs/Pharmacy #10409
Fayetteville, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D2216511 belongs to Cvs/Pharmacy #10409 in Fayetteville, AR.
Certificate of Waiver, effective March 12, 2025, expires March 11, 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
- March 12, 2025
- Certificate expiration
- March 11, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- March 12, 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
- 04D2216511
- Lab name
- Cvs/Pharmacy #10409
- Additional name
- Arkansas CVS Pharmacy, LLC
- Address
- 2402 N College Avenue, Fayetteville, AR 72703
- Phone
- (401) 770-6431
- Fax
- (401) 216-0381
Annual test volume the lab reported
- Waived tests
- 13,000
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 Cvs/Pharmacy #10409 in Fayetteville?
04D2216511, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Cvs/Pharmacy #10409 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D2216511 expire?
The CMS file lists March 11, 2027 as the certificate expiration date; the certificate took effect March 12, 2025.