04D2311953 CLIA NUMBER - MVP WARREN

Laboratory Demographics

  • CLIA Code: 04D2311953
  • Facility Name: MVP WARREN
  • Facility Address: 101 N MAIN ST
    WARREN, AR
    ZIP 71671
  • Facility Phone: 870 226-3751
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHARLES STATEN
  • NPI Number: 1023423423
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2311953
LAB Type Pharmacy
Facility Name MVP WARREN
Street 101 N MAIN ST
City WARREN
State AR
ZIP 71671
Phone 870 226-3751
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/2/2024
Certificate Expiration Date 10/1/2026
Facility Type Pharmacy
Lab Director CHARLES STATEN

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