04D2275316 CLIA NUMBER - COLLIER DRUG - WILLOW CREEK

Laboratory Demographics

  • CLIA Code: 04D2275316
  • Facility Name: COLLIER DRUG - WILLOW CREEK
  • Facility Address: 5201 WILLOW CREEK ROAD
    SPRINGDALE, AR
    ZIP 72762
  • Facility Phone: 479 521-7876
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RICKY WIRT
  • NPI Number: 1609877414
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2275316
LAB Type Pharmacy
Facility Name COLLIER DRUG - WILLOW CREEK
Street 5201 WILLOW CREEK ROAD
City SPRINGDALE
State AR
ZIP 72762
Phone 479 521-7876
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/19/2025
Certificate Expiration Date 1/18/2027
Facility Type Pharmacy
Lab Director RICKY WIRT

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