04D2139445 CLIA NUMBER - WALMART PHARMACY 10-0530

Laboratory Demographics

  • CLIA Code: 04D2139445
  • Facility Name: WALMART PHARMACY 10-0530
  • Facility Address: 2730 N WEST AVE
    EL DORADO, AR
    ZIP 71730
  • Facility Phone: 870 862-4866
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KELSIE ROGERS
  • NPI Number: 1780601187
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 04D2139445
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0530
Street 2730 N WEST AVE
City EL DORADO
State AR
ZIP 71730
Phone 870 862-4866
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 KELSIE ROGERS

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