04D2062967 CLIA NUMBER - WALGREENS #10240

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Laboratory Demographics

CLIA Number: 04D2062967

Facility Name: WALGREENS #10240

Facility Address:
5500 HIGHWAY 5 N
BRYANT, AR
ZIP 72022
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Facility Phone Number: 501 847-7420

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1972544393

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	04D2062967
LAB Type	Pharmacy
Facility Name	WALGREENS #10240
Street	5500 HIGHWAY 5 N
City	BRYANT
State	AR
ZIP	72022
Phone	501 847-7420
CertificateType	4
CertificateEffectiveDate	4/27/2023
CertificateExpirationDate	4/26/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024