04D2063053 CLIA NUMBER - WALGREENS #03412

Laboratory Demographics

  • CLIA Code: 04D2063053
  • Facility Name: WALGREENS #03412
  • Facility Address: 5917 BASELINE RD
    LITTLE ROCK, AR
    ZIP 72209
  • Facility Phone: 501 565-7844
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SARAH E. ZULFER
  • NPI Number: 1194730457
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2063053
LAB Type Pharmacy
Facility Name WALGREENS #03412
Street 5917 BASELINE RD
City LITTLE ROCK
State AR
ZIP 72209
Phone 501 565-7844
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/8/2023
Certificate Expiration Date 6/7/2025
Facility Type Pharmacy
Lab Director SARAH E. ZULFER

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This page was last updated on: 6/4/2025