04D2154382 CLIA NUMBER - BAKER DRUG STORE

Laboratory Demographics

  • CLIA Code: 04D2154382
  • Facility Name: BAKER DRUG STORE
  • Facility Address: 924 FRONT STREET
    CONWAY, AR
    ZIP 72032
  • Facility Phone: 501 329-5626
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMES A. DALLAS
  • NPI Number: 1306843016
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2154382
LAB Type Pharmacy
Facility Name BAKER DRUG STORE
Street 924 FRONT STREET
City CONWAY
State AR
ZIP 72032
Phone 501 329-5626
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/11/2024
Certificate Expiration Date 9/10/2026
Facility Type Pharmacy
Lab Director JAMES A. DALLAS

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