04D2235853 CLIA NUMBER - MITCHELL'S PARK STREET PHARMACY, INC

Laboratory Demographics

  • CLIA Code: 04D2235853
  • Facility Name: MITCHELL'S PARK STREET PHARMACY, INC
  • Facility Address: 526 PARK STREET
    CALICO ROCK, AR
    ZIP 72519
  • Facility Phone: 870 297-8107
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. SARAH B. MITCHELL
  • NPI Number: 1780665034
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 04D2235853
LAB Type Pharmacy
Facility Name MITCHELL'S PARK STREET PHARMACY, INC
Street 526 PARK STREET
City CALICO ROCK
State AR
ZIP 72519
Phone 870 297-8107
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/13/2025
Certificate Expiration Date 9/12/2027
Facility Type Pharmacy
Lab Director MS. SARAH B. MITCHELL

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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