04D2289933 CLIA NUMBER - WESTSIDE FAMILY PHARMACY

Laboratory Demographics

CLIA Number: 04D2289933

Facility Name: WESTSIDE FAMILY PHARMACY

Facility Address:
3819 W SUNSET AVE
SPRINGDALE, AR
ZIP 72762
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Facility Phone Number: 479 756-3232

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1386761757

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	04D2289933
LAB Type	Pharmacy
Facility Name	WESTSIDE FAMILY PHARMACY
Street	3819 W SUNSET AVE
City	SPRINGDALE
State	AR
ZIP	72762
Phone	479 756-3232
CertificateType	4
CertificateEffectiveDate	9/18/2023
CertificateExpirationDate	9/17/2025
FacilityType	Waiver

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