CLIA lab
CLIA 04D2338829: Millard Henry Clinic ST Mary's Physician Services
Russellville, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D2338829 belongs to Millard Henry Clinic ST Mary's Physician Services in Russellville, AR.
Certificate of Waiver, effective February 18, 2026, expires February 17, 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 18, 2026
- Certificate expiration
- February 17, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- February 18, 2026
- Facility type
- Rural health clinic
- 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
- 04D2338829
- Lab name
- Millard Henry Clinic ST Mary's Physician Services
- Address
- 101 Skyline Drive Suite A, Russellville, AR 72801
- Phone
- (479) 968-2345
- Fax
- (479) 890-2497
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.
Affiliated CLIA numbers
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 Millard Henry Clinic ST Mary's Physician Services in Russellville?
04D2338829, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Millard Henry Clinic ST Mary's Physician Services hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D2338829 expire?
The CMS file lists February 17, 2028 as the certificate expiration date; the certificate took effect February 18, 2026.