04D2139421 CLIA NUMBER - WALMART PHARMACY 10-0036

Laboratory Demographics

  • CLIA Code: 04D2139421
  • Facility Name: WALMART PHARMACY 10-0036
  • Facility Address: 2802 W KINGSHIGHWAY
    PARAGOULD, AR
    ZIP 72450
  • Facility Phone: 870 236-7785
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. JOHN FINLEY
  • NPI Number: 1326408196
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2139421
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0036
Street 2802 W KINGSHIGHWAY
City PARAGOULD
State AR
ZIP 72450
Phone 870 236-7785
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/3/2023
Certificate Expiration Date 11/2/2025
Facility Type Pharmacy
Lab Director MR. JOHN FINLEY

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