04D2150359 CLIA NUMBER - CORNER DRUG STORE

Laboratory Demographics

  • CLIA Code: 04D2150359
  • Facility Name: CORNER DRUG STORE
  • Facility Address: 830 E MAIN ST
    MELBOURNE, AR
    ZIP 72556
  • Facility Phone: 870 368-7171
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ABBY A. EVERETT
  • NPI Number: 1326015371
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2150359
LAB Type Pharmacy
Facility Name CORNER DRUG STORE
Street 830 E MAIN ST
City MELBOURNE
State AR
ZIP 72556
Phone 870 368-7171
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/22/2024
Certificate Expiration Date 6/21/2026
Facility Type Pharmacy
Lab Director ABBY A. EVERETT

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