04D2183143 CLIA NUMBER - TANGLEWOOD DRUGSTORE RXMOOSE INC

Laboratory Demographics

  • CLIA Code: 04D2183143
  • Facility Name: TANGLEWOOD DRUGSTORE RXMOOSE INC
  • Facility Address: 6815 CANTRELL ROAD
    LITTLE ROCK, AR
    ZIP 72207
  • Facility Phone: 501 664-4444
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ADAM E. WHEELER
  • NPI Number: 1396750998
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2183143
LAB Type Pharmacy
Facility Name TANGLEWOOD DRUGSTORE RXMOOSE INC
Street 6815 CANTRELL ROAD
City LITTLE ROCK
State AR
ZIP 72207
Phone 501 664-4444
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/30/2024
Certificate Expiration Date 4/29/2026
Facility Type Pharmacy
Lab Director ADAM E. WHEELER

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