04D2278090 CLIA NUMBER - WHITEHALL PHARMACY LLC #4

Laboratory Demographics

  • CLIA Code: 04D2278090
  • Facility Name: WHITEHALL PHARMACY LLC #4
  • Facility Address: 2701 E HARDING AVE
    PINE BLUFF, AR
    ZIP 71601
  • Facility Phone: 870 380-6901
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FLOYD L. STICE
  • NPI Number: 1285349530
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2278090
LAB Type Pharmacy
Facility Name WHITEHALL PHARMACY LLC #4
Street 2701 E HARDING AVE
City PINE BLUFF
State AR
ZIP 71601
Phone 870 380-6901
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/10/2025
Certificate Expiration Date 3/9/2027
Facility Type Pharmacy
Lab Director FLOYD L. STICE

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