04D2157115 CLIA NUMBER - ECONO-MART PHARMACY

Laboratory Demographics

  • CLIA Code: 04D2157115
  • Facility Name: ECONO-MART PHARMACY
  • Facility Address: 1595 HARRISON STREET
    BATESVILLE, AR
    ZIP 72501
  • Facility Phone: 870 793-4179
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PAUL T. HOLIFIELD
  • NPI Number: 1679568729
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2157115
LAB Type Pharmacy
Facility Name ECONO-MART PHARMACY
Street 1595 HARRISON STREET
City BATESVILLE
State AR
ZIP 72501
Phone 870 793-4179
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/30/2024
Certificate Expiration Date 10/29/2026
Facility Type Pharmacy
Lab Director PAUL T. HOLIFIELD

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