04D2222073 CLIA NUMBER - WALGREENS #12912

Laboratory Demographics

  • CLIA Code: 04D2222073
  • Facility Name: WALGREENS #12912
  • Facility Address: 705 W CENTER ST
    GREENWOOD, AR
    ZIP 72936
  • Facility Phone: 479 996-5522
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KRISTIN E. NEEL
  • NPI Number: 1508097379
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2222073
LAB Type Pharmacy
Facility Name WALGREENS #12912
Street 705 W CENTER ST
City GREENWOOD
State AR
ZIP 72936
Phone 479 996-5522
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/27/2025
Certificate Expiration Date 4/26/2027
Facility Type Pharmacy
Lab Director KRISTIN E. NEEL

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