04D2069323 CLIA NUMBER - WALGREENS #10666

Laboratory Demographics

  • CLIA Code: 04D2069323
  • Facility Name: WALGREENS #10666
  • Facility Address: 640 W GIANES ST
    MONTICELLO, AR
    ZIP 71655
  • Facility Phone: 870 367-6146
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SARAH C. LADD
  • NPI Number: 1497962088
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2069323
LAB Type Pharmacy
Facility Name WALGREENS #10666
Street 640 W GIANES ST
City MONTICELLO
State AR
ZIP 71655
Phone 870 367-6146
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 SARAH C. LADD

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