01D2196611 CLIA NUMBER - THREE NOTCH PHARMACY THREE NOTCH PHARMACY, LLC

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Laboratory Demographics

CLIA Number: 01D2196611

Facility Name: THREE NOTCH PHARMACY THREE NOTCH PHARMACY, LLC

Facility Address:
4880 LAKELAND DRIVE, SUITE F
MOBILE, AL
ZIP 36619
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Facility Phone Number: 251 661-0066

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1881963460

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	01D2196611
LAB Type	Pharmacy
Facility Name	THREE NOTCH PHARMACY THREE NOTCH PHARMACY, LLC
Street	4880 LAKELAND DRIVE, SUITE F
City	MOBILE
State	AL
ZIP	36619
Phone	251 661-0066
CertificateType	4
CertificateEffectiveDate	10/19/2022
CertificateExpirationDate	10/18/2024
FacilityType	Waiver

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