04D0890620 CLIA NUMBER - CITY PHARMACY

Laboratory Demographics

  • CLIA Code: 04D0890620
  • Facility Name: CITY PHARMACY
  • Facility Address: 1801 SOUTH BROADWAY
    LITTLE ROCK, AR
    ZIP 72206
  • Facility Phone: 501 374-6565
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GARY B. BASS
  • NPI Number: 1841291150
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 04D0890620
LAB Type Pharmacy
Facility Name CITY PHARMACY
Street 1801 SOUTH BROADWAY
City LITTLE ROCK
State AR
ZIP 72206
Phone 501 374-6565
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/23/2024
Certificate Expiration Date 8/22/2026
Facility Type Pharmacy
Lab Director GARY B. BASS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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