Healther Providers Data Logo

04D2183796 CLIA NUMBER - HEARTLAND PHARMACY FAYETTEVILLE

Laboratory Demographics

CLIA Number: 04D2183796

Facility Name: HEARTLAND PHARMACY FAYETTEVILLE

Facility Address:
1450 E ZION RD, SUITE 1
FAYETTEVILLE, AR
ZIP 72703
Get Directions

Facility Phone Number: 479 444-7200

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1689113136

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name Field Value
CLIA Number 04D2183796
LAB Type Pharmacy
Facility Name HEARTLAND PHARMACY FAYETTEVILLE
Street 1450 E ZION RD, SUITE 1
City FAYETTEVILLE
State AR
ZIP 72703
Phone 479 444-7200
CertificateType 4
CertificateEffectiveDate 5/11/2022
CertificateExpirationDate 5/10/2024
FacilityType Waiver

Download Record

Download this CLIA NUMBER record in Text format: Export

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

Download this CLIA NUMBER record in XML format: Export

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