04D2311209 CLIA NUMBER - WALGREENS 21433

Laboratory Demographics

  • CLIA Code: 04D2311209
  • Facility Name: WALGREENS 21433
  • Facility Address: 800 E CENTERTON BLVD
    CENTERTON, AR
    ZIP 72719
  • Facility Phone: 479 224-7002
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LINDSAY L. CAFFELLE
  • NPI Number: 1023718863
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2311209
LAB Type Pharmacy
Facility Name WALGREENS 21433
Street 800 E CENTERTON BLVD
City CENTERTON
State AR
ZIP 72719
Phone 479 224-7002
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/18/2024
Certificate Expiration Date 9/17/2026
Facility Type Pharmacy
Lab Director LINDSAY L. CAFFELLE

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