04D2063055 CLIA NUMBER - WALGREENS #15702

Laboratory Demographics

  • CLIA Code: 04D2063055
  • Facility Name: WALGREENS #15702
  • Facility Address: 424 CALIFORNIA AVE SW
    CAMDEN, AR
    ZIP 71701
  • Facility Phone: 870 836-4157
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AUSTIN D. LAMBERT
  • NPI Number: 1982787396
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2063055
LAB Type Pharmacy
Facility Name WALGREENS #15702
Street 424 CALIFORNIA AVE SW
City CAMDEN
State AR
ZIP 71701
Phone 870 836-4157
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2025
Certificate Expiration Date 8/28/2027
Facility Type Pharmacy
Lab Director AUSTIN D. LAMBERT

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