04D2192866 CLIA NUMBER - MEDICINE SHOPPE, THE DAVID'S PHARMACY

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Laboratory Demographics

CLIA Number: 04D2192866

Facility Name: MEDICINE SHOPPE, THE DAVID'S PHARMACY

Facility Address:
3836 JOHN F KENNEDY
NORTH LITTLE ROCK, AR
ZIP 72116
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Facility Phone Number: 501 758-1010

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1790890713

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	04D2192866
LAB Type	Physician Office
Facility Name	MEDICINE SHOPPE, THE DAVID'S PHARMACY
Street	3836 JOHN F KENNEDY
City	NORTH LITTLE ROCK
State	AR
ZIP	72116
Phone	501 758-1010
CertificateType	4
CertificateEffectiveDate	9/15/2022
CertificateExpirationDate	9/14/2024
FacilityType	Waiver

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