04D2154320 CLIA NUMBER - AMITY ROAD PHARMACY

Laboratory Demographics

  • CLIA Code: 04D2154320
  • Facility Name: AMITY ROAD PHARMACY
  • Facility Address: 810 AMITY RD, SUITE 101
    CONWAY, AR
    ZIP 72032
  • Facility Phone: 501 358-3863
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNIFER A. HYDE
  • NPI Number: 1821335845
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2154320
LAB Type Pharmacy
Facility Name AMITY ROAD PHARMACY
Street 810 AMITY RD, SUITE 101
City CONWAY
State AR
ZIP 72032
Phone 501 358-3863
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/11/2024
Certificate Expiration Date 9/10/2026
Facility Type Pharmacy
Lab Director JENNIFER A. HYDE

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