04D2272805 CLIA NUMBER - SAM ALEXANDER PHARMACY

Laboratory Demographics

  • CLIA Code: 04D2272805
  • Facility Name: SAM ALEXANDER PHARMACY
  • Facility Address: 127 N MAIN ST
    HARRISON, AR
    ZIP 72601
  • Facility Phone: 870 741-6511
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: REBEKAH E. HEARN
  • NPI Number: 1518953132
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2272805
LAB Type Pharmacy
Facility Name SAM ALEXANDER PHARMACY
Street 127 N MAIN ST
City HARRISON
State AR
ZIP 72601
Phone 870 741-6511
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/30/2024
Certificate Expiration Date 11/29/2026
Facility Type Pharmacy
Lab Director REBEKAH E. HEARN

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