04D2056345 CLIA NUMBER - WALGREENS #13811

Laboratory Demographics

  • CLIA Code: 04D2056345
  • Facility Name: WALGREENS #13811
  • Facility Address: 3251 W SUNSET AVE
    SPRINGDALE, AR
    ZIP 72762
  • Facility Phone: 479 756-1290
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANDREW R. CRISWELL
  • NPI Number: 1659628212
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2056345
LAB Type Pharmacy
Facility Name WALGREENS #13811
Street 3251 W SUNSET AVE
City SPRINGDALE
State AR
ZIP 72762
Phone 479 756-1290
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/8/2025
Certificate Expiration Date 6/7/2027
Facility Type Pharmacy
Lab Director ANDREW R. CRISWELL

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