CLIA lab
CLIA 04D2271630: Shannan Souza Aprn LLC
Pottsville, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D2271630 belongs to Shannan Souza Aprn LLC in Pottsville, AR.
Certificate of Waiver, effective November 4, 2024, expires November 3, 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
- November 4, 2024
- Certificate expiration
- November 3, 2026
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- November 4, 2022
- Facility type
- Other practitioner
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 1
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 04D2271630
- Lab name
- Shannan Souza Aprn LLC
- Address
- 5150A SR 247, Pottsville, AR 72858
- Phone
- (479) 567-5680
- Fax
- (479) 567-5679
Annual test volume the lab reported
- Waived tests
- 100
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 Shannan Souza Aprn LLC in Pottsville?
04D2271630, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Shannan Souza Aprn LLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D2271630 expire?
The CMS file lists November 3, 2026 as the certificate expiration date; the certificate took effect November 4, 2024.