04D2273176 CLIA NUMBER - EUDORA PHARMACY, INC

Laboratory Demographics

  • CLIA Code: 04D2273176
  • Facility Name: EUDORA PHARMACY, INC
  • Facility Address: 200 S MAIN STREET
    EUDORA, AR
    ZIP 71640
  • Facility Phone: 870 355-2046
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KHALIL L. CROUSE
  • NPI Number: 1275548828
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2273176
LAB Type Pharmacy
Facility Name EUDORA PHARMACY, INC
Street 200 S MAIN STREET
City EUDORA
State AR
ZIP 71640
Phone 870 355-2046
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/8/2024
Certificate Expiration Date 12/7/2026
Facility Type Pharmacy
Lab Director KHALIL L. CROUSE

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