CLIA lab
CLIA 04D2343902: Dmhc at Providence Park
Mabelvale, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D2343902 belongs to Dmhc at Providence Park in Mabelvale, AR.
Certificate of Waiver, effective May 14, 2026, expires May 13, 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
- May 14, 2026
- Certificate expiration
- May 13, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- May 14, 2026
- Facility type
- Physician office
- Ownership (control type)
- Private
- 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
- 04D2343902
- Lab name
- Dmhc at Providence Park
- Address
- 103 Peace St, Mabelvale, AR 72103
- Phone
- (501) 441-5558
- Fax
- (501) 441-4041
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.
Other labs in Mabelvale, AR
Related
Questions
What is the CLIA number for Dmhc at Providence Park in Mabelvale?
04D2343902, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Dmhc at Providence Park hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D2343902 expire?
The CMS file lists May 13, 2028 as the certificate expiration date; the certificate took effect May 14, 2026.