04D2063041 CLIA NUMBER - WALGREENS #05535

Laboratory Demographics

  • CLIA Code: 04D2063041
  • Facility Name: WALGREENS #05535
  • Facility Address: 4634 N HIGHWAY 7
    HOT SPRINGS VILLAGE, AR
    ZIP 71909
  • Facility Phone: 501 984-4151
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOE BENTON
  • NPI Number: 1285649541
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2063041
LAB Type Pharmacy
Facility Name WALGREENS #05535
Street 4634 N HIGHWAY 7
City HOT SPRINGS VILLAGE
State AR
ZIP 71909
Phone 501 984-4151
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/27/2025
Certificate Expiration Date 4/26/2027
Facility Type Pharmacy
Lab Director JOE BENTON

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