04D2216513 CLIA NUMBER - CVS/PHARMACY #10666 ARKANSAS CVS PHARMACY , LLC

Laboratory Demographics

  • CLIA Code: 04D2216513
  • Facility Name: CVS/PHARMACY #10666 ARKANSAS CVS PHARMACY , LLC
  • Facility Address: 110 SOUTHWEST DR
    JONESBORO, AR
    ZIP 72401
  • Facility Phone: 401 770-6431
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CASEY JONES
  • NPI Number: 1225050008
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2216513
LAB Type Pharmacy
Facility Name CVS/PHARMACY #10666 ARKANSAS CVS PHARMACY , LLC
Street 110 SOUTHWEST DR
City JONESBORO
State AR
ZIP 72401
Phone 401 770-6431
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/12/2025
Certificate Expiration Date 3/11/2027
Facility Type Pharmacy
Lab Director CASEY JONES

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