04D2190810 CLIA NUMBER - CLINTON DRUG

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Laboratory Demographics

CLIA Number: 04D2190810

Facility Name: CLINTON DRUG

Facility Address:
2526 US-65 SOUTH
CLINTON, AR
ZIP 72031
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Facility Phone Number: (501) 745-4970

Facility Type: PHARMACY

Certificate Type: Waiver

NPI Number: 1235624875

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name	Field Value
CLIA Number	04D2190810
LAB Type	PHARMACY
Facility Name	CLINTON DRUG
Street	2526 US-65 SOUTH
City	CLINTON
State	AR
ZIP	72031
Phone	(501) 745-4970

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This page was last updated on: 5/11/2023