44D2206709 CLIA NUMBER - ROMAN PHARMACY

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Laboratory Demographics

CLIA Number: 44D2206709

Facility Name: ROMAN PHARMACY

Facility Address:
250 LONG HOLLOW PIKE
GOODLETTSVILLE, TN
ZIP 37072
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Facility Phone Number: 615 859-8999

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1134405681

Taxonomy: 3336C0004X - Pharmacy
A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.

CLIA Record

Field Name	Field Value
CLIA Number	44D2206709
LAB Type	Pharmacy
Facility Name	ROMAN PHARMACY
Street	250 LONG HOLLOW PIKE
City	GOODLETTSVILLE
State	TN
ZIP	37072
Phone	615 859-8999
CertificateType	4
CertificateEffectiveDate	12/22/2022
CertificateExpirationDate	12/21/2024
FacilityType	Waiver

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