04D2289586 CLIA NUMBER - RANDOLPH COUNTY DRUG

Laboratory Demographics

  • CLIA Code: 04D2289586
  • Facility Name: RANDOLPH COUNTY DRUG
  • Facility Address: 567 HWY 67 S
    POCAHONTAS, AR
    ZIP 72455
  • Facility Phone: 870 202-2536
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GREGGORY T. LANCE II
  • NPI Number: 1063955672
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 04D2289586
LAB Type Pharmacy
Facility Name RANDOLPH COUNTY DRUG
Street 567 HWY 67 S
City POCAHONTAS
State AR
ZIP 72455
Phone 870 202-2536
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/13/2025
Certificate Expiration Date 9/12/2027
Facility Type Pharmacy
Lab Director GREGGORY T. LANCE II

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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