04D2144463 CLIA NUMBER - EXPRESS RX OF CABOT NW CABOT, LLC

Laboratory Demographics

  • CLIA Code: 04D2144463
  • Facility Name: EXPRESS RX OF CABOT NW CABOT, LLC
  • Facility Address: 1848 W MAIN ST, STE B
    CABOT, AR
    ZIP 72023
  • Facility Phone: 501 843-1489
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ERIC CRUMBAUGH
  • NPI Number: 1225499619
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2144463
LAB Type Pharmacy
Facility Name EXPRESS RX OF CABOT NW CABOT, LLC
Street 1848 W MAIN ST, STE B
City CABOT
State AR
ZIP 72023
Phone 501 843-1489
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/3/2024
Certificate Expiration Date 4/2/2026
Facility Type Pharmacy
Lab Director ERIC CRUMBAUGH

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