04D2304860 CLIA NUMBER - CARAWAY DRUG L L C

Laboratory Demographics

  • CLIA Code: 04D2304860
  • Facility Name: CARAWAY DRUG L L C
  • Facility Address: 201 E STATE STREET
    CARAWAY, AR
    ZIP 72419
  • Facility Phone: 870 956-0300
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRADLEY T. HAMILTON
  • NPI Number: 1326674870
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2304860
LAB Type Pharmacy
Facility Name CARAWAY DRUG L L C
Street 201 E STATE STREET
City CARAWAY
State AR
ZIP 72419
Phone 870 956-0300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2024
Certificate Expiration Date 5/20/2026
Facility Type Pharmacy
Lab Director BRADLEY T. HAMILTON

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