04D2188837 CLIA NUMBER - DRUG STORE INC

Laboratory Demographics

  • CLIA Code: 04D2188837
  • Facility Name: DRUG STORE INC
  • Facility Address: 11121 N RODNEY PARHAM
    LITTLE ROCK, AR
    ZIP 72212
  • Facility Phone: 501 223-2636
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PHILIP A. JUDD
  • NPI Number: 1013188168
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D2188837
LAB Type Pharmacy
Facility Name DRUG STORE INC
Street 11121 N RODNEY PARHAM
City LITTLE ROCK
State AR
ZIP 72212
Phone 501 223-2636
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/22/2024
Certificate Expiration Date 7/21/2026
Facility Type Pharmacy
Lab Director PHILIP A. JUDD

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