04D2249271 CLIA NUMBER - CORNERSTONE MAIN STREET

Laboratory Demographics

CLIA Number: 04D2249271

Facility Name: CORNERSTONE MAIN STREET

Facility Address:
1701 MAIN STREET
LITTLE ROCK, AR
ZIP 72206
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Facility Phone Number: 501 246-5451

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1790139111

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	04D2249271
LAB Type	Pharmacy
Facility Name	CORNERSTONE MAIN STREET
Street	1701 MAIN STREET
City	LITTLE ROCK
State	AR
ZIP	72206
Phone	501 246-5451
CertificateType	4
CertificateEffectiveDate	1/19/2024
CertificateExpirationDate	1/18/2026
FacilityType	Waiver

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