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04D2154511 CLIA NUMBER - CORNERSTONE PHARMACY

Laboratory Demographics

CLIA Number: 04D2154511

Facility Name: CORNERSTONE PHARMACY

Facility Address:
4220 NORTH RODNEY PARHAM
LITTLE ROCK, AR
ZIP 72212
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Facility Phone Number: 501 223-2224

Facility Type: Independent

Certificate Type: Waiver
NPI Number: 1538584552

Taxonomy: 3336C0004X - Pharmacy
A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.

CLIA Record

Field Name Field Value
CLIA Number 04D2154511
LAB Type Independent
Facility Name CORNERSTONE PHARMACY
Street 4220 NORTH RODNEY PARHAM
City LITTLE ROCK
State AR
ZIP 72212
Phone 501 223-2224
CertificateType 4
CertificateEffectiveDate 9/14/2022
CertificateExpirationDate 9/13/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024