04D2013530 CLIA NUMBER - WALGREENS #10198

Laboratory Demographics

  • CLIA Code: 04D2013530
  • Facility Name: WALGREENS #10198
  • Facility Address: 2135 N WEST AVE
    EL DORADO, AR
    ZIP 71730
  • Facility Phone: 870 862-5458
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNA D. HUITT
  • NPI Number: 1568477826
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2013530
LAB Type Pharmacy
Facility Name WALGREENS #10198
Street 2135 N WEST AVE
City EL DORADO
State AR
ZIP 71730
Phone 870 862-5458
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/7/2025
Certificate Expiration Date 6/6/2027
Facility Type Pharmacy
Lab Director JENNA D. HUITT

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This page was last updated on: 6/4/2025