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04D2289639 CLIA NUMBER - COLLIER DRUG CAVE SPRINGS

Laboratory Demographics

CLIA Number: 04D2289639

Facility Name: COLLIER DRUG CAVE SPRINGS

Facility Address:
260 S GLEANEAGLE DR, SUITE A
CAVE SPRINGS, AR
ZIP 72718
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Facility Phone Number: 479 203-7014

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1730950775

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name Field Value
CLIA Number 04D2289639
LAB Type Pharmacy
Facility Name COLLIER DRUG CAVE SPRINGS
Street 260 S GLEANEAGLE DR, SUITE A
City CAVE SPRINGS
State AR
ZIP 72718
Phone 479 203-7014
CertificateType 4
CertificateEffectiveDate 9/13/2023
CertificateExpirationDate 9/12/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024