04D2194404 CLIA NUMBER - MITCHELL'S MAIN STREET PHARMACY

Laboratory Demographics

  • CLIA Code: 04D2194404
  • Facility Name: MITCHELL'S MAIN STREET PHARMACY
  • Facility Address: 214 EAST MAIN
    MOUNTAIN VIEW, AR
    ZIP 72560
  • Facility Phone: 870 269-3253
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: EDWARD J. MITCHELL
  • NPI Number: 1447503941
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2194404
LAB Type Pharmacy
Facility Name MITCHELL'S MAIN STREET PHARMACY
Street 214 EAST MAIN
City MOUNTAIN VIEW
State AR
ZIP 72560
Phone 870 269-3253
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/30/2024
Certificate Expiration Date 9/29/2026
Facility Type Pharmacy
Lab Director EDWARD J. MITCHELL

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