04D2131256 CLIA NUMBER - MEDICAL ARTS PHARMACY

Laboratory Demographics

  • CLIA Code: 04D2131256
  • Facility Name: MEDICAL ARTS PHARMACY
  • Facility Address: 2515 E HUNTSVILLE RD
    FAYETTEVILLE, AR
    ZIP 72701
  • Facility Phone: 479 443-3411
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PHILLIP R. ROZELL
  • NPI Number: 1003203878
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2131256
LAB Type Pharmacy
Facility Name MEDICAL ARTS PHARMACY
Street 2515 E HUNTSVILLE RD
City FAYETTEVILLE
State AR
ZIP 72701
Phone 479 443-3411
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/24/2023
Certificate Expiration Date 5/23/2025
Facility Type Pharmacy
Lab Director PHILLIP R. ROZELL

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This page was last updated on: 3/20/2025