01D2192487 CLIA NUMBER - GRAND BAY PHARMACY NEW GRAND BAY PHARMACY, LLC

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Laboratory Demographics

CLIA Number: 01D2192487

Facility Name: GRAND BAY PHARMACY NEW GRAND BAY PHARMACY, LLC

Facility Address:
12475 HWY 90
GRAND BAY, AL
ZIP 36541
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Facility Phone Number: 251 865-5555

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1467766865

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	01D2192487
LAB Type	Pharmacy
Facility Name	GRAND BAY PHARMACY NEW GRAND BAY PHARMACY, LLC
Street	12475 HWY 90
City	GRAND BAY
State	AL
ZIP	36541
Phone	251 865-5555
CertificateType	4
CertificateEffectiveDate	9/10/2022
CertificateExpirationDate	9/9/2024
FacilityType	Waiver

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