04D2037574 CLIA NUMBER - WALGREENS #09624

Laboratory Demographics

  • CLIA Code: 04D2037574
  • Facility Name: WALGREENS #09624
  • Facility Address: 705 HWY 62 65 NORTH
    HARRISON, AR
    ZIP 72601
  • Facility Phone: 870 365-0459
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JESSICA R. COX
  • NPI Number: 1154336428
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2037574
LAB Type Pharmacy
Facility Name WALGREENS #09624
Street 705 HWY 62 65 NORTH
City HARRISON
State AR
ZIP 72601
Phone 870 365-0459
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/12/2025
Certificate Expiration Date 4/11/2027
Facility Type Pharmacy
Lab Director JESSICA R. COX

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