01D2163851 CLIA NUMBER - SPECIALTY PHARMACY

Laboratory Demographics

CLIA Number: 01D2163851

Facility Name: SPECIALTY PHARMACY

Facility Address:
2104 AL HWY 157
CULLMAN, AL
ZIP 35058
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Facility Phone Number: 256 734-3146

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1255321295

Taxonomy: 3336S0011X - Pharmacy
A pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration.

CLIA Record

Field Name	Field Value
CLIA Number	01D2163851
LAB Type	Pharmacy
Facility Name	SPECIALTY PHARMACY
Street	2104 AL HWY 157
City	CULLMAN
State	AL
ZIP	35058
Phone	256 734-3146
CertificateType	4
CertificateEffectiveDate	3/22/2023
CertificateExpirationDate	3/21/2025
FacilityType	Waiver

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