04D2319008 CLIA NUMBER - WALGREENS 21551

Laboratory Demographics

  • CLIA Code: 04D2319008
  • Facility Name: WALGREENS 21551
  • Facility Address: 5805 DOLLARWAY ROAD
    PINE BLUFF, AR
    ZIP 71602
  • Facility Phone: 870 247-5854
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LARNA D. ATKINSON
  • NPI Number: 1083391809
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2319008
LAB Type Pharmacy
Facility Name WALGREENS 21551
Street 5805 DOLLARWAY ROAD
City PINE BLUFF
State AR
ZIP 71602
Phone 870 247-5854
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/21/2025
Certificate Expiration Date 2/20/2027
Facility Type Pharmacy
Lab Director LARNA D. ATKINSON

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