04D2255925 CLIA NUMBER - CVS PHARMACY 10816 ARKANSAS CVS PHARMACY LLC

Laboratory Demographics

  • CLIA Code: 04D2255925
  • Facility Name: CVS PHARMACY 10816 ARKANSAS CVS PHARMACY LLC
  • Facility Address: 1749 WALNUT ST
    ROGERS, AR
    ZIP 72756
  • Facility Phone: 866 389-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MADISON FORTHMAN
  • NPI Number: 1437609369
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2255925
LAB Type Pharmacy
Facility Name CVS PHARMACY 10816 ARKANSAS CVS PHARMACY LLC
Street 1749 WALNUT ST
City ROGERS
State AR
ZIP 72756
Phone 866 389-2727
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/18/2024
Certificate Expiration Date 3/17/2026
Facility Type Pharmacy
Lab Director MADISON FORTHMAN

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