CLIA lab
CLIA 04D2284769: River Valley Surgery Center
Russellville, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D2284769 belongs to River Valley Surgery Center in Russellville, AR.
Certificate of Waiver, effective June 28, 2025, expires June 27, 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
- June 28, 2025
- Certificate expiration
- June 27, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- June 28, 2023
- Facility type
- Ambulatory surgery center
- 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
- 04D2284769
- Lab name
- River Valley Surgery Center
- Address
- 3110 West Main Street, Russellville, AR 72801
- Phone
- (479) 967-7770
- Fax
- (479) 967-7772
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 Russellville, AR
- Ar Heart Hospital Rural Health Svcs - RussellvilleCertificate of Waiver, Physician office04D1096786
- Arcare 92Certificate of Waiver, Federally qualified health center04D2308343
- Arcare 98Certificate of Waiver, Federally qualified health center04D2329669
- Arkansas DermatologyCertificate of Compliance, Physician office04D2178013
- Arkansas Dermatology CenterCertificate for Provider-Performed Microscopy Procedures, Physician office04D0949890
- Arkansas Occupational Health Clinic - RussellvilleCertificate of Waiver, Physician office04D2119425
- Arkansas Renal Group, PA - RussellvilleCertificate of Waiver, Physician office04D2112078
- Arkansas Tech University Health & Wellness CenterCertificate for Provider-Performed Microscopy Procedures, School or student health service04D0909870
- Arkansas Urology/RussellvilleCertificate for Provider-Performed Microscopy Procedures, Physician office04D1100397
- BPC Plasma, IncCertificate of Accreditation, Independent04D2162256
Related
Questions
What is the CLIA number for River Valley Surgery Center in Russellville?
04D2284769, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does River Valley Surgery Center hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D2284769 expire?
The CMS file lists June 27, 2027 as the certificate expiration date; the certificate took effect June 28, 2025.