CLIA lab
CLIA 04D2254057: Mobile Diagnostic Laboratory Inc
Pine Bluff, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D2254057 belongs to Mobile Diagnostic Laboratory Inc in Pine Bluff, AR.
Certificate of Waiver, effective February 28, 2026, expires February 28, 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
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- February 28, 2026
- Certificate expiration
- February 28, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- February 28, 2022
- 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
- 04D2254057
- Lab name
- Mobile Diagnostic Laboratory Inc
- Address
- 703 West Pullen Street, Pine Bluff, AR 71601
- Phone
- (870) 433-0096
- Fax
- (870) 433-0686
Annual test volume the lab reported
- Waived tests
- 500
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Pine Bluff, AR
- Ach Pine Bluff ClinicCertificate of Waiver, Physician office04D0465263
- Arcare 140Certificate of Waiver, Federally qualified health center04D2349439
- Arcare 155Certificate of Waiver, Federally qualified health center04D2325162
- Archwell Health - Pine BluffCertificate of Waiver, Physician office04D2315883
- Arkansas Dept of Correction Health SVCCertificate of Waiver, Other02D0682823
- Autonomy Healthcare ProvidersCertificate of Waiver, Physician office04D2271274
- Buckhanan RecoveryCertificate of Waiver, Other04D2299468
- Cavhs Pine BluffCertificate of Accreditation, Community clinic04D2185025
- Central Arkansas Radiation Therapy InstituteCertificate of Accreditation, Physician office04D2194416
- Children's Advocacy Center of Southeast ArkansasCertificate of Waiver, Other04D2275776
Related
Questions
What is the CLIA number for Mobile Diagnostic Laboratory Inc in Pine Bluff?
04D2254057, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Mobile Diagnostic Laboratory Inc hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D2254057 expire?
The CMS file lists February 28, 2028 as the certificate expiration date; the certificate took effect February 28, 2026.