04D2310200 CLIA NUMBER - FAMILY CARE PHARMACY

Laboratory Demographics

  • CLIA Code: 04D2310200
  • Facility Name: FAMILY CARE PHARMACY
  • Facility Address: 93 HWY 63B SUITE A
    MARKED TREE, AR
    ZIP 72365
  • Facility Phone: 870 358-2484
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DONNI J. ROACH
  • NPI Number: 1932271590
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2310200
LAB Type Pharmacy
Facility Name FAMILY CARE PHARMACY
Street 93 HWY 63B SUITE A
City MARKED TREE
State AR
ZIP 72365
Phone 870 358-2484
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2024
Certificate Expiration Date 8/28/2026
Facility Type Pharmacy
Lab Director DONNI J. ROACH

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