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04D2184661 CLIA NUMBER - COMMUNITY PHARMACY OF SPRINGDALE MCKINNEY DRUG STORE

Laboratory Demographics

CLIA Number: 04D2184661

Facility Name: COMMUNITY PHARMACY OF SPRINGDALE MCKINNEY DRUG STORE

Facility Address:
400 W EMMA AVENUE
SPRINGDALE, AR
ZIP 72764
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Facility Phone Number: 479 750-2220

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1023445293

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 04D2184661
LAB Type Pharmacy
Facility Name COMMUNITY PHARMACY OF SPRINGDALE MCKINNEY DRUG STORE
Street 400 W EMMA AVENUE
City SPRINGDALE
State AR
ZIP 72764
Phone 479 750-2220
CertificateType 4
CertificateEffectiveDate 5/22/2022
CertificateExpirationDate 5/21/2024
FacilityType Waiver

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