04D2013527 CLIA NUMBER - WALGREENS #09743

Laboratory Demographics

  • CLIA Code: 04D2013527
  • Facility Name: WALGREENS #09743
  • Facility Address: 350 HWY 62 E
    MOUNTAIN HOME, AR
    ZIP 72653
  • Facility Phone: 870 434-3814
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GARRETT C. ENGLISH
  • NPI Number: 1972518249
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 04D2013527
LAB Type Pharmacy
Facility Name WALGREENS #09743
Street 350 HWY 62 E
City MOUNTAIN HOME
State AR
ZIP 72653
Phone 870 434-3814
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/31/2025
Certificate Expiration Date 3/30/2027
Facility Type Pharmacy
Lab Director GARRETT C. ENGLISH

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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