04D2063281 CLIA NUMBER - WALGREENS #15789

Laboratory Demographics

  • CLIA Code: 04D2063281
  • Facility Name: WALGREENS #15789
  • Facility Address: 701 W GROVE ST
    EL DORADO, AR
    ZIP 71730
  • Facility Phone: 870 881-8434
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CARLEIGH E. FARRAR
  • NPI Number: 1790868107
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 04D2063281
LAB Type Pharmacy
Facility Name WALGREENS #15789
Street 701 W GROVE ST
City EL DORADO
State AR
ZIP 71730
Phone 870 881-8434
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/18/2025
Certificate Expiration Date 8/17/2027
Facility Type Pharmacy
Lab Director CARLEIGH E. FARRAR

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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