04D2239760 CLIA NUMBER - WALGREENS #09593

Laboratory Demographics

  • CLIA Code: 04D2239760
  • Facility Name: WALGREENS #09593
  • Facility Address: 3499 BELLA VISTA WAY
    BELLA VISTA, AR
    ZIP 72714
  • Facility Phone: 479 273-9136
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. RACHEL E. REEVES
  • NPI Number: 1245245513
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2239760
LAB Type Pharmacy
Facility Name WALGREENS #09593
Street 3499 BELLA VISTA WAY
City BELLA VISTA
State AR
ZIP 72714
Phone 479 273-9136
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/14/2025
Certificate Expiration Date 10/13/2027
Facility Type Pharmacy
Lab Director MS. RACHEL E. REEVES

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