03D2210700 CLIA NUMBER - RIVERSIDE PHARMACY

Laboratory Demographics

CLIA Number: 03D2210700

Facility Name: RIVERSIDE PHARMACY

Facility Address:
2410 HIGHWAY 95
BULLHEAD CITY, AZ
ZIP 86442
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Facility Phone Number: 928 219-4700

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1356961726

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	03D2210700
LAB Type	Pharmacy
Facility Name	RIVERSIDE PHARMACY
Street	2410 HIGHWAY 95
City	BULLHEAD CITY
State	AZ
ZIP	86442
Phone	928 219-4700
CertificateType	4
CertificateEffectiveDate	1/22/2023
CertificateExpirationDate	1/21/2025
FacilityType	Waiver

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