04D2156702 CLIA NUMBER - DELTA DRUG, INC

Laboratory Demographics

  • CLIA Code: 04D2156702
  • Facility Name: DELTA DRUG, INC
  • Facility Address: 257 S HWY 18 BYPASS
    MANILA, AR
    ZIP 72442
  • Facility Phone: 870 561-3113
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEREMY A. JACKSON
  • NPI Number: 1043318041
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2156702
LAB Type Pharmacy
Facility Name DELTA DRUG, INC
Street 257 S HWY 18 BYPASS
City MANILA
State AR
ZIP 72442
Phone 870 561-3113
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/23/2024
Certificate Expiration Date 10/22/2026
Facility Type Pharmacy
Lab Director JEREMY A. JACKSON

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