04D2269189 CLIA NUMBER - ROSE DRUG OF DARDANELLE

Laboratory Demographics

  • CLIA Code: 04D2269189
  • Facility Name: ROSE DRUG OF DARDANELLE
  • Facility Address: 1176 W STATE HWY 22 STE A
    DARDANELLE, AR
    ZIP 72834
  • Facility Phone: 479 229-4040
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARSHA L. DUVALL
  • NPI Number: 1063410223
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 04D2269189
LAB Type Pharmacy
Facility Name ROSE DRUG OF DARDANELLE
Street 1176 W STATE HWY 22 STE A
City DARDANELLE
State AR
ZIP 72834
Phone 479 229-4040
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/22/2024
Certificate Expiration Date 9/21/2026
Facility Type Pharmacy
Lab Director MARSHA L. DUVALL

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