04D2139515 CLIA NUMBER - WALMART PHARMACY 10-2587

Laboratory Demographics

  • CLIA Code: 04D2139515
  • Facility Name: WALMART PHARMACY 10-2587
  • Facility Address: 304 S ROCKWOOD DR
    CABOT, AR
    ZIP 72023
  • Facility Phone: 501 941-5300
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. TAMARA L. MCFADDEN
  • NPI Number: 1598782997
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2139515
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2587
Street 304 S ROCKWOOD DR
City CABOT
State AR
ZIP 72023
Phone 501 941-5300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/6/2023
Certificate Expiration Date 11/5/2025
Facility Type Pharmacy
Lab Director MS. TAMARA L. MCFADDEN

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