04D1017082 CLIA NUMBER - MEDICINE SHOPPE,THE

Laboratory Demographics

  • CLIA Code: 04D1017082
  • Facility Name: MEDICINE SHOPPE,THE
  • Facility Address: 325 SOUTHWEST DRIVE
    JONESBORO, AR
    ZIP 72401
  • Facility Phone: 870 935-1340
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PRESTON JONES
  • NPI Number: 1285706069
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D1017082
LAB Type Pharmacy
Facility Name MEDICINE SHOPPE,THE
Street 325 SOUTHWEST DRIVE
City JONESBORO
State AR
ZIP 72401
Phone 870 935-1340
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/16/2025
Certificate Expiration Date 9/15/2027
Facility Type Pharmacy
Lab Director PRESTON JONES

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