04D0994755 CLIA NUMBER - VILLAGE PHARMACY

Laboratory Demographics

  • CLIA Code: 04D0994755
  • Facility Name: VILLAGE PHARMACY
  • Facility Address: 500 W COMMERCIAL ST
    OZARK, AR
    ZIP 72949
  • Facility Phone: 501 667-2101
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: C A. KUYKENDALL
  • NPI Number: 1740361500
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D0994755
LAB Type Pharmacy
Facility Name VILLAGE PHARMACY
Street 500 W COMMERCIAL ST
City OZARK
State AR
ZIP 72949
Phone 501 667-2101
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/28/2023
Certificate Expiration Date 12/27/2025
Facility Type Pharmacy
Lab Director C A. KUYKENDALL

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This page was last updated on: 9/29/2025