04D2294783 CLIA NUMBER - GREENWOOD PHARMACY

Laboratory Demographics

  • CLIA Code: 04D2294783
  • Facility Name: GREENWOOD PHARMACY
  • Facility Address: 560 W CENTER STREET
    GREENWOOD, AR
    ZIP 72936
  • Facility Phone: 479 996-2000
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TANNER COOPER
  • NPI Number: 1467213629
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2294783
LAB Type Pharmacy
Facility Name GREENWOOD PHARMACY
Street 560 W CENTER STREET
City GREENWOOD
State AR
ZIP 72936
Phone 479 996-2000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/30/2023
Certificate Expiration Date 11/29/2025
Facility Type Pharmacy
Lab Director TANNER COOPER

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