CLIA lab
CLIA 04D2319161: Rostollan Family Practice, Aesthetics & Wellness
Mena, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D2319161 belongs to Rostollan Family Practice, Aesthetics & Wellness in Mena, AR.
Certificate of Waiver, effective February 25, 2025, expires February 24, 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
- February 25, 2025
- Certificate expiration
- February 24, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- February 25, 2025
- Facility type
- Other practitioner
- 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
- 04D2319161
- Lab name
- Rostollan Family Practice, Aesthetics & Wellness
- Address
- 403 N Morrow Street, Suite D, Mena, AR 71953
- Phone
- (479) 385-2444
- Fax
- (479) 385-2445
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 Rostollan Family Practice, Aesthetics & Wellness in Mena?
04D2319161, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Rostollan Family Practice, Aesthetics & Wellness hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D2319161 expire?
The CMS file lists February 24, 2027 as the certificate expiration date; the certificate took effect February 25, 2025.