04D2137892 CLIA NUMBER - TEASLEY DRUG

Laboratory Demographics

  • CLIA Code: 04D2137892
  • Facility Name: TEASLEY DRUG
  • Facility Address: 205 ALTANTA SE
    GRAVETTE, AR
    ZIP 72736
  • Facility Phone: 479 787-5966
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. LINDSEY S. WATFORD
  • NPI Number: 1275645269
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 04D2137892
LAB Type Pharmacy
Facility Name TEASLEY DRUG
Street 205 ALTANTA SE
City GRAVETTE
State AR
ZIP 72736
Phone 479 787-5966
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/5/2025
Certificate Expiration Date 10/4/2027
Facility Type Pharmacy
Lab Director MS. LINDSEY S. WATFORD

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