04D2014192 CLIA NUMBER - WALGREENS #06765

Laboratory Demographics

  • CLIA Code: 04D2014192
  • Facility Name: WALGREENS #06765
  • Facility Address: 108 E HIGHLAND DR
    JONESBORO, AR
    ZIP 72401
  • Facility Phone: 870 802-3749
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALICIA M. LEWALLEN
  • NPI Number: 1093720351
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2014192
LAB Type Pharmacy
Facility Name WALGREENS #06765
Street 108 E HIGHLAND DR
City JONESBORO
State AR
ZIP 72401
Phone 870 802-3749
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/3/2025
Certificate Expiration Date 10/2/2027
Facility Type Pharmacy
Lab Director ALICIA M. LEWALLEN

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