04D2275319 CLIA NUMBER - COLLIER DRUG - CENTERTON

Laboratory Demographics

  • CLIA Code: 04D2275319
  • Facility Name: COLLIER DRUG - CENTERTON
  • Facility Address: 991 W CENTERTON BLVD
    CENTERTON, AR
    ZIP 72719
  • Facility Phone: 479 795-8199
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TATUM WARRELL
  • NPI Number: 1275528069
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2275319
LAB Type Pharmacy
Facility Name COLLIER DRUG - CENTERTON
Street 991 W CENTERTON BLVD
City CENTERTON
State AR
ZIP 72719
Phone 479 795-8199
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 TATUM WARRELL

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