04D2167294 CLIA NUMBER - CAVE CITY PHARMACY

Laboratory Demographics

  • CLIA Code: 04D2167294
  • Facility Name: CAVE CITY PHARMACY
  • Facility Address: 301 S MAIN STREET STE C
    CAVE CITY, AR
    ZIP 72521
  • Facility Phone: 870 283-5589
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNIFER L. DAVIS
  • NPI Number: 1043340789
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2167294
LAB Type Pharmacy
Facility Name CAVE CITY PHARMACY
Street 301 S MAIN STREET STE C
City CAVE CITY
State AR
ZIP 72521
Phone 870 283-5589
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/5/2025
Certificate Expiration Date 6/4/2027
Facility Type Pharmacy
Lab Director JENNIFER L. DAVIS

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