04D2243533 CLIA NUMBER - EXPRESS RX OF PINE BLUFF

Laboratory Demographics

  • CLIA Code: 04D2243533
  • Facility Name: EXPRESS RX OF PINE BLUFF
  • Facility Address: 3006 WEAT 28TH AVENUE
    PINE BLUFF, AR
    ZIP 71603
  • Facility Phone: 870 850-0159
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ERIC CRUMBAUGH
  • NPI Number: 1578995007
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2243533
LAB Type Pharmacy
Facility Name EXPRESS RX OF PINE BLUFF
Street 3006 WEAT 28TH AVENUE
City PINE BLUFF
State AR
ZIP 71603
Phone 870 850-0159
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/19/2023
Certificate Expiration Date 11/18/2025
Facility Type Pharmacy
Lab Director ERIC CRUMBAUGH

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