04D2063024 CLIA NUMBER - WALGREENS #03425

Laboratory Demographics

  • CLIA Code: 04D2063024
  • Facility Name: WALGREENS #03425
  • Facility Address: 159 E GRAND AVE
    HOT SPRINGS, AR
    ZIP 71901
  • Facility Phone: 501 624-5598
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LUCAS R. MARKHAM
  • NPI Number: 1477568731
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2063024
LAB Type Pharmacy
Facility Name WALGREENS #03425
Street 159 E GRAND AVE
City HOT SPRINGS
State AR
ZIP 71901
Phone 501 624-5598
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 LUCAS R. MARKHAM

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