04D2206296 CLIA NUMBER - ARCH STREET PHARMACY

Laboratory Demographics

  • CLIA Code: 04D2206296
  • Facility Name: ARCH STREET PHARMACY
  • Facility Address: 11200 ARCH STREET
    LITTLE ROCK, AR
    ZIP 72206
  • Facility Phone: 501 261-7181
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. CHARLIE TUCKER
  • NPI Number: 1669826954
  • Taxonomy: 183500000X - Pharmacist

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CLIA Record

Field Name Field Value
CLIA Number 04D2206296
LAB Type Pharmacy
Facility Name ARCH STREET PHARMACY
Street 11200 ARCH STREET
City LITTLE ROCK
State AR
ZIP 72206
Phone 501 261-7181
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/18/2024
Certificate Expiration Date 12/17/2026
Facility Type Pharmacy
Lab Director MR. CHARLIE TUCKER

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