04D2013020 CLIA NUMBER - WALGREENS #05260

Laboratory Demographics

  • CLIA Code: 04D2013020
  • Facility Name: WALGREENS #05260
  • Facility Address: 2701 ROGERS AVE
    FORT SMITH, AR
    ZIP 72901
  • Facility Phone: 479 783-4782
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RABIA AFZAL
  • NPI Number: 1245246610
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2013020
LAB Type Pharmacy
Facility Name WALGREENS #05260
Street 2701 ROGERS AVE
City FORT SMITH
State AR
ZIP 72901
Phone 479 783-4782
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/27/2023
Certificate Expiration Date 4/26/2025
Facility Type Pharmacy
Lab Director RABIA AFZAL

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This page was last updated on: 3/20/2025